on November 23, 2005
Published online before print November 23, 2005, doi: 10.1161/01.ATV.0000197844.06411.22
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Submitted on August 2, 2005
Accepted on November 2, 2005
Vascular Function and Mild Renal Impairment in Stable Coronary Artery Disease
Pim van der Harst *;
From the Departments of Cardiology (P.v.d.H., T.D.J.S., A.A.V., D.J.v.V.), Clinical Pharmacology (P.v.d.H., H.B., W.H.v.G.), and Internal Medicine Division of Nephrology (G.N.), University Medical Center Groningen, University of Groningen, The Netherlands.
* To whom correspondence should be addressed. E-mail: p.van.der.harst{at}thorax.umcg.nl.
Objective--In patients with coronary artery disease, the concomitant presence of renal function impairment is associated with decreased survival. We aimed to assess whether in coronary artery diseased patients renal function impairment is associated with systemic vascular function, functional parameters of the renin-angiotensin system, or inflammation as potential mediators for cardiovascular risk.
Methods and Results--We studied 125 patients, 87% male, with a mean age of 62.2±8.2 years; 72% had 3-vessel disease, and mean renal function was 74±13 mL/min per 1.73 m2. Internal thoracic artery rings were sampled during coronary bypass surgery and used for in vitro vascular measurements. We could not establish an association between endothelium-dependent vasorelaxation (response to methacholine) and renal function. In addition, vascular response to potassium chloride, phenylephrine, and angiotensin II were not associated with renal function. Finally, serum angiotensin-converting enzyme activity, usage of inhibitors, C-reactive protein, and soluble intercellular adhesion molecule 1 were not related to renal function.
Conclusions--In coronary artery disease patients, mild renal function impairment is not associated with systemic vasomotor responsiveness, inflammation, or functional systemic parameters of the renin-angiotensin system. The relation between systemic endothelial dysfunction and mild renal insufficiency might be more complicated than previously thought.
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