as an indication of myocardial ischemia in chronic kidney
disease patients
Mohamed F. Almaghrabya,b, Abeer A. Mahmouda,b
Background
Nicotinamide phosphoribosyltransferase (Visfatin), an enzyme involved in the NAD+ salvage
pathway, has been shown to help in the regulation of glucose homeostasis. It is a highly
conserved, 52 kDa protein found in living species from bacteria to humans. It is an adipokine
produced and secreted primarily by adipose tissue. Chronic kidney disease (CKD) and
end-stage renal disease patients showed increased cardiovascular mortality, and vascular
events account for more than half of the deaths in this population. Myocardial ischemia is a
consequence of coronary heart disease. Recent studies found that with increasing visfatin
levels, CKD patients have a larger number of vessels with stenosis and a higher likelihood of
coronary artery disease.
Research design and methods
The current prospective study includes 137 CKD patients and patients with chest pain (CP),
as well as 20 patients as controls. Patient data included age, sex, comorbidities, smoking
status, weight, height, and BMI, calculated using the equation: BMI = weight (kg)/height (m2).
Estimated glomerular fi ltration rate was calculated using the modifi ed Modifi cation of Diet in
Renal Disease equations; in addition, enzyme-linked immunosorbent assay was used to estimate
serum visfatin levels, and CP was assessed through a modifi cation of the master questionnaire.
Results
All patients had signifi cantly (P < 0.05) higher serum visfatin levels compared with controls.
Patients who had typical anginal CP had signifi cantly (P < 0.05) higher serum visfatin levels
compared with those who had atypical anginal or nonanginal CP, with nonsignifi cantly (P > 0.05)
higher serum visfatin levels in patients with atypical anginal CP compared with those with
nonanginal CP. Moreover, patients with stage 4 CKD had a signifi cantly (P < 0.05) higher
serum visfatin level compared with patients with stage 3 CKD.
Conclusion
It could be concluded that patients with CKD are at an actual risk of developing CP secondary
to myocardial ischemic attack, presenting either as typical or as atypical anginal pain. Elevated
serum visfatin levels may be the cornerstone for the relationship between CKD and coronary
heart disease. Serum visfatin levels in range of 12. 4–16.4 ng/ml could predict the possibility
of developing an anginal attack in patients with atypical anginal CP, with high sensitivity and |
