title: Relationship between renal function at the time of percutaneous coronary intervention and prognosis in ischemic heart disease patients.
abstract: BACKGROUND
  As hypertension and diabetes mellitus increase, the number of patients developing complications of cardiovascular disease (CVD) associated with conventional risk factors is increasing. In addition to these risk factors for CVD, chronic kidney disease (CKD) has also been reported to play an important role. We investigated the association of representative ischemic heart disease and CKD.
  
  
  METHODS
  Between July 1, 2000, and June 30, 2005, a total of 790 patients who underwent percutaneous coronary intervention (PCI) for angina pectoris or myocardial infarction in our division of cardiovascular disease were reviewed. Serum markers at the implementation of PCI were compared in patients classified according to renal function. For prognosis, in-hospital mortality, 1-year survival rate, overall mortality, and CVD death were investigated. Changes in renal function were also monitored during the follow-up period. The glomerular filtration rate (GFR) was calculated by the Modification of Diet in Renal Disease Study Group (MDRD) formula.
  
  
  RESULTS
  The mean estimated GFR (eGFR) at PCI implementation was 66.2 +/- 21.0 ml/min/1.73 m(2). Stage 2 CKD was shown in 51.5% of all the patients. During the overall follow-up period, 126 patients died. With the progression of CKD stage, all-cause, CVD, and in-hospital mortality increased, and the 1-year survival rate decreased. It was proved that a medical history of hypertension, hyperlipidemia, and diabetes, multiple vessel lesions, hypoalbuminemia, C-reactive protein (CRP), and estimated GFR were independent risk factors for all-cause death. In CVD death, in addition to the above risk factors, anemia and total cholesterol were also an independent risk factor. Renal function deteriorated significantly during the follow-up period.
  
  
  CONCLUSIONS
  Patients with ischemic heart disease requiring PCI often develop renal dysfunction, which may considerably affect prognosis.
authors: Department of Nephrology and Rheumatology, Tosei General Hospital, 160 Nishioiwake-cho, Seto, Aichi 489-8642, Japan. dinaguma@r8.dion.ne.jp
authors: Daijo
authors: D
authors: Inaguma
authors: Miho
authors: M
authors: Tatematsu
authors: Hibiki
authors: H
authors: Shinjo
authors: Sachiyo
authors: S
authors: Suzuki
authors: Tomoko
authors: T
authors: Mishima
authors: Shinichiro
authors: S
authors: Inaba
authors: Kei
authors: K
authors: Kurata
authors: Yukio
authors: Y
authors: Yuzawa
authors: Seiichi
authors: S
authors: Matsuo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis