Abstract 1994: Anemia and Chronic Kidney Disease (CKD) are powerful predictors for Presence and Severity of Coronary Artery Disease (CAD)
BACKGROUND: Patients (pts) with chronic kidney disease (CKD) carry a higher risk of cardiovascular disease. Whether anemia confers a higher risk is less studied.
OBJECTIVE: This study sought to ascertain whether CAD as determined by myocardial perfusion imaging is more common among pts with anemia (Hb: Hemoglobin <<26> 13 g/l) and CKD (GFR: glomerular filtration rate ≤ 60 ml/min/1.73 Kg/m2)
METHOD: A total of 1580 pts ( mean age 65 + −10 y/o, 43% diabetics) with suspected CAD underwent clinical, ECG, laboratory evaluation and gated myocardial perfusion SPECT. Patients were divided into 4 groups according to their Hb and GFR. (1: No Anemia/No CKD n = 800, 2: CKD/No anemia n = 332, 3: Anemia/No CKD n = 195, 4: Anemia and CKD n = 253).
RESULTS: Compared to group of pts with normal Hb and GFR, myocardial perfusion defect is more common in those with anemia and CKD. (Group 1: 48%, Group 2: 65%, Group 3: 59 %, Group 4: 72%, al P < 0.05) Patients with CKD and anemia also exhibited a more severe coronary heart disease (mean summed stress score: SSS 6.5 + − 4 vs. 4.5 + −7 P < 0.01) In addition, the prevalence of high-riskscan findings predictive of worse prognosis (SSS ≥ 8, transient ischemic dilation, or left ventricular ejection fraction ≤ 40%) was also higher in pts with anemia and CKD than those with normal Hb and GFR (Group 1: 28 %, Group 2: 38%, Group 3: 38%, Group 4: 48 %, al P < 0.05) After adjusting for clinical and ECG information, anemia and CKD are associated with a higher risk of perfusion defect and high-risk scan. The association was stronger among those with combined anemia and CKD. (See table⇓)
CONCLUSION: Both anemia and CKD are independent predictor of coronary heart disease. Pts with both anemia and CKD were almost twice more likely to have high risk CAD than those with normal Hb and renal function.