ABSTRACT
Diabetes mellitus [DM] is the most prevalent metabolic disease worldwide and is associated with coronary artery disease [CAD]. Therefore it is very important to find a clue to diagnose the presence of CAD as early as possible in DM patients. The aim of this study was to find any correlation between microalbuminuria [MAU] and the severity of CAD in patients with DM type 2. This was a cross sectional study that included 77 DM type 2 patients with suspected CAD that all of whom were performed coronary angiography in our hospital [from 2010 to 2011]. Patients were divided into two groups, the case group [group 1] that includes patients with MAU and the control group [group 2] that include patients without MAU. Severity of CAD was estimated by using Gensini score and MAU was defined as the ratio of urine albumin to urine creatinine. Of 77 patients forty three [55.8%] were female, mean +/- SD of their ages was 55.8 +/- 10.3 and sixteen [21%] of them had MAU. Gensini score of case group was significantly higher than control group [94.94 +/- 12 versus 33.25 +/- 25.4, P<0.001]. The linear regression analysis revealed urinary albumin to creatinine ratio [UA/CR] as an independent predictor for the severity of CAD [P<0.001]. Based on the ROC curve, 10.25 was the best albumin level cut off point for differentiating Gensini score over and below 70. Area under curve was 0.9; sensitivity and specificity were 72% and 80%, respectively [P<0.001]. According to this study, in patients with DM type2, MAU is an independent predictor of severity of coronary artery stenosis and reveals a positive correlation between MAU and the Gensini score
ABSTRACT
The aim of the present investigation was to explore probable association of renal artery stenosis [RAS] with coronary artery disease [CAD] and the prevalence of renal artery stenosis [RAS] in patients with CAD. This study comprised 165 consecutive patients with CAD, including 52.7% males and 47.2% females with respective mean ages of 60.3 +/- 8.9 and 59.5 +/- 10.1. The patients underwent simultaneous coronary and renal angiographies, and the lumen reduction of 50% or more was considered as significant stenosis. Indeed, stenosis of more than 70% of the arterial lumen was regarded as severe. According to our findings, the prevalence of renal artery stenosis in our hypertensive and normotensive patients were 46.2% and 19.5% respectively [p=0.002]. Renal artery angiography revealed that 64 [38.8%] of the patients had simultaneous renal artery stenosis. RAS is more common in females than males [p=0.031]. Multivariate analysis revealed that among all examined factors, hypertension and serum creatinine were associated with RAS. There was no correlations found between gensini score and RAS [p=0.63]. We found a relatively high prevalence of RAS including 46.2% in hypertensive and 19.5% in normotensive patients in our patients with CAD