Glomerular hyperfiltration: An independent risk factor and predictor of advanced coronary artery disease.

Abstract

Objective: To determine frequency and patterns of coronary artery disease in patients with glomerular hyper filtration (GHF), presented with acute coronary syndrome (ACS). Study Design: Cross Sectional, Retrospective study. Setting: Tertiary Healthcare Centre, Karachi. Period: July 2018 to July 2021. Material & Methods: Twelve hundred and sixty seven patients undergone Coronary angiography (CAG) for ACS having estimated glomerular filtration rate (eGFR) calculated through Cockcroft-Gault equation >90ml/min were selected. They were divided into two groups on the basis of eGFR, group A with normal eGFR (90-120ml/min) and B with eGFR i-e >120ml/min with glomerular hyper filtration (GHF). Variables like age, gender, BMI, Diabetes mellitus (DM), Hypertension, Smoking, history of previous cardiovascular diseases (CVD) and family history of CVD and obesity were studied. Findings of CAG results from Cath lab were also noted down. All the relevant data was analyzed through SPSS 16. Results: Out of 1267 patients 807 patients had normal eGFR and 460 had GHF. Mean age in two groups was 45± 8.5years and 45.6± 7.8years, mean eGFR 102ml/min and 146ml/min and mean B.P was 110/80 and 135/90 mmHg respectively. Association of GHF with younger age, mean B.P, BMI, and family history of obesity was significant P value <0.05. Patients with GHF had significant Coronary artery disease (CAD) P-0.036. Patients with eGFR between 145-175ml/mid had worst angiographic results, 80% of those had CAD. Conclusion: GHF has strong association with CVD and is a predictor of severity of disease.