The Relationship Between Kidney Function and Angiographically-Derived SYNTAX Score

Background: Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD) and is an independent risk factor for adverse cardiovascular disease (CVD) and all-cause mortality in patients with acute coronary syndromes. SYNTAX score (SXscore) can predict the outcomes of patients undergoing percutaneous coronary intervention. However, the association between kidney function and SXscore has not been previously reported. Methods: The estimated glomerular filtration rate (eGFR) and SXscore were retrospectively collected in 2262 patients with established CAD undergoing coronary angiography at Peking University Third Hospital from March 2005 to September 2010. Ordinal logistic regression and Pearson and partial correlation were used to analyze the association between eGFR and SXscore. Results: Patients with renal dysfunction were older, more likely to be female, and have a history of hypertension and diabetes. The unadjusted correlation coefficient of eGFR and SXscore was -0.125 (P < 0.001). This remained significant after adjustment for age, sex, hypertension, diabetes, hyperlipidemia, or current smoking (r = -0.075, P = 0.019). Ordinal logistic regression showed that age, gender, diabetes, and eGFR exerted independent influences on SXscore. Conclusions: Kidney function was an independent predictor of SXscore in patients with established CAD. This helps explain the increased risk of cardiovascular disease events and mortality in patients with renal dysfunction. Further prospective multicentre studies are needed to confirm this finding.