Preoperative estimated glomerular filtration rate as a significant predictor of long-term outcomes after coronary artery bypass grafting in Japanese patients

被引：13

作者：

Domoto S. ^{[1
]}

Tagusari O. ^{[1
]}

Nakamura Y. ^{[1
]}

Takai H. ^{[1
]}

Seike Y. ^{[1
]}

Ito Y. ^{[1
]}

Shibuya Y. ^{[2
]}

Shikata F. ^{[3
]}

机构：

[1] Department of Cardiovascular Surgery, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo 141-8625

[2] Department of Hypertension and Nephrology, NTT Medical Center Tokyo, Shinagawa-ku, Tokyo 141-8625

[3] Division of Cardiovascular Surgery, Ehime University, Shitsukawa, Toon-shi

来源：

General Thoracic and Cardiovascular Surgery | 2014年 / 62卷 / 2期

关键词：

Chronic kidney disease; Coronary artery bypass grafting; Estimated glomerular filtration rate; Long-term outcomes;

D O I：

10.1007/s11748-013-0306-5

中图分类号：

学科分类号：

摘要：

Purposes: The aim of this retrospective study was to investigate the effect of chronic kidney disease (CKD) on outcomes after coronary artery bypass grafting (CABG), and to determine whether preoperative estimated glomerular filtration rate (eGFR) can be a predictor of long-term outcomes after CABG. Methods: 486 Japanese patients who underwent isolated CABG between December 2000 and August 2010 were evaluated. Preoperative eGFR was estimated by the Japanese equation according to guidelines from the Japanese Society of Nephrology. We defined CKD as a preoperative eGFR of less than 60 ml/min/1.73 m2. 203 patients had CKD (CK group) and 283 patients did not (N group). Results: During a mean observation time of 53 months, the overall survival rate was significantly lower in the CK group than in the N group (p = 0.0044). Similarly, the CK group had significantly more unfavorable results with regard to freedom from cardiac death, major adverse cardiovascular and cerebrovascular events (MACCE), and hemodialysis. Using multivariate analyses, preoperative eGFR was an independent predictor of all-cause mortality (HR 0.983; p = 0.026), cardiac mortality (HR 0.963; p = 0.006), and incidence of MACCE (HR 0.983; p = 0.002). Conclusions: The CK group had significantly more unfavorable outcomes than the N group. Preoperative eGFR was an independent predictor of long-term outcomes after CABG in Japanese patients. © 2013 The Author(s).

引用

页码：95 / 102

页数：7

共 30 条

[1] Liu J.Y., Birkmeyer N.J.O., Sanders J.H., Morton J.R., Henriques H.F., Lahey S.J., Et al., Risk of mortality in dialysis patients undergoing coronary artery bypass surgery, Circulation, 102, pp. 2973-2977, (2000)
[2] Labrousse L., De Vincentiis C., Madonna F., Deville C., Roques X., Baudet E., Early and long term results of coronary artery bypass grafts in patients with dialysis dependant renal failure, European Journal of Cardio-thoracic Surgery, 15, 5, pp. 691-696, (1999)
[3] Khaitan L., Sutter F.P., Goldman S.M., Coronary artery bypass grafting in patients who require long-term dialysis, Annals of Thoracic Surgery, 69, 4, pp. 1135-1139, (2000)
[4] Nakayama Y., Sakata R., Ura M., Itoh T., Long-term results of coronary artery bypass grafting in patients with renal insufficiency, Annals of Thoracic Surgery, 75, 2, pp. 496-500, (2003)
[5] Devbhandari M.P., Duncan A.J., Grayson A.D., Fabri B.M., Keenan D.J.M., Bridgewater B., Jones M.T., Au J., Effect of risk-adjusted, non-dialysis-dependent renal dysfunction on mortality and morbidity following coronary artery bypass surgery: A multi-centre study, European Journal of Cardio-thoracic Surgery, 29, 6, pp. 964-970, (2006)
[6] Weerasinghe A., Hornick P., Smith P., Taylor K., Ratnatunga C., Coronary artery bypass grafting in non-dialysis dependent mild-to-moderate renal dysfunction, J Thorac Cardiovasc Surg, 121, pp. 1083-1089, (2000)
[7] Rao V., Weisel R.D., Buth K.J., Cohen G., Borger M.A., Shiono N., Et al., Coronary artery bypass grafting in patients with non-dialysis-dependent renal insufficiency, Circulation, 96, pp. 38-43, (1997)
[8] Zakeri R., Freemantle N., Barnett V., Lipkin G.W., Bonser R.S., Graham T.R., Et al., Relation between mild renal dysfunction and outcomes after coronary artery bypass grafting, Circulation, 112, (2005)
[9] Van Straten A.H.M., Hamad M.A.S., Van Zundert A.A.J., Martens E.J., Schonberger J.P.A.M., De Wolf A.M., Preoperative renal function as a predictor of survival after coronary artery bypass grafting: Comparison with a matched general population, J Thorac Cardiovasc Surg, 138, pp. 971-976, (2009)
[10] Holzmann M.J., Hammar N., Ahnve S., Nordqvist T., Pehrsson K., Ivert T., Renal insufficiency and long-term mortality and incidence of myocardial infarction in patients undergoing coronary artery bypass grafting, European Heart Journal, 28, 7, pp. 865-871, (2007)

← 1 2 3 →