The Investigation Of The Relationship Between Renal Dysfunction And Coronary Heart Disease

Objective 1.Understanding of the changes of renal function in patients with coronary heart disease and non-coronary heart disease. 2.The analysis of relationship of renal dysfunction and the risk factors of coronary heart disease.3.To evaluate the relationship of renal dysfunction, coronary heart disease and percutaneous coronary intervention(PCI) .4.To provide research basis for improving the prognosis, prevention and treatment of patients with coronary heart disease .Methods 1. The subjects:There were 376 patients who come from department of cardiology of our hospital in this study undergoing coronary angiography. The patients were divided into two groups according to coronary angiography: i.e. coronary artery disease (group A, n=263), in which 141 patients with renal dysfunction (group A1) and 122 patients with normal renal function (group A2): patients with other kinds of cardiovascular disease but normal coronary angiography (group B. n=113). Before the coronary angiography, all patients were measured the serum creatinine, microalbuminuria, fasting blood-glucose, triglycerides, total cholesterol, high density lipoprotein, low density lipoprotein, and blood pressure in fasting 12 hours. 2.The diagnostic criteria for renal dysfunction: serum creatinine >115umol/L and/or microalbuminuria >30mg for male, >107umol/L and/or>30mg for female.Result 1. The differences of renal function indexes in the group A and B : The mean level of microalbuminuria and serum creatinine was higher significantly in group A than that of the group B (43.48±38.93 vs 11.23±7.07 and 101.52±37.22 vs 80.62±17.4 respectively, P <0.001); 2. The differences of the coronary angiography finding in the group A1 and A2: The incidence of triple-vessel lesions(50.3% vs 36.8%;), the diffuse lesions(48% vs 28%)), the number of lesion coronary artery(2.35±0.84vs2.03±0.74), and the coronary artery score (8.63±3.49vs7.01±3.72) were higher significantly in group A1 than that of the group A2 respectively (P<0.01). The mean level of microalbuminuria and serum creatinine was higher significantly in patients with triple-vessel lesions than that of the patients with single-vessellesion(57.44±50.02 vs 25.15±19.64 and 109.98±42.88 vs 91.95±33.25, respectively, P<0.01); 3.The number of PCI patients were higher significantly in group A1 than that of the group A2 (68%vs54%,P<0.05); the number of pieces of stent implantation were aslo higher significantly in group A1 than that of the group A2(2.02±0.89 vs 1.69±0.84,P<0.05); 4. The mean level of microalbuminuria and serum creatinine had a positive correlated with the degree of coronary artery disease, age, blood glucose, systolic blood pressure, and had a negative correlated with left ventricular ejection fraction (P<0.05-0.01, respectively).Conclusions The coronary heart disease patients with renal dysfunction had more severe coronary artery stenosis, higher percentage of multiple-vascular disease, higher coronary artery score, higher percentage of coronary artery diffuse lesions and more patients needed PCI treatment. The renal dysfunction is a strong and independent risk factors for the coronary heart disease and beeds more revascularization therapy.