title: Prevalence and impact of renal insufficiency on clinical outcomes of patients undergoing coronary revascularization.
abstract: BACKGROUND
  Patients with renal insufficiency are more likely to die after coronary revascularization, but mild renal insufficiency is neglected and little is known about its clinical effects.
  
  
  RESULTS
  In the present study 3,025 patients grouped by estimated creatinine clearance (CrCl) were analyzed to evaluate the association between CrCl and clinical outcome. The mean serum creatinine was 1.0+/-0.4 mg/dl, with 4.3% above normal; in 65.8% CrCl was <90 ml/min. During hospitalization, there were significant differences in mortality among the groups stratified by CrCl (p<0.0001). During follow-up after hospital discharge, there were significant differences in mortality (p<0.0001), new-onset myocardial infarction (p=0.007), and stroke (p=0.032). In patients with severe renal insufficiency, the in-hospital and follow-up mortality reached 15.4% and 31.3%, respectively. The independent risk factors for all-cause death after revascularization were the mode of revascularization, age and the CrCl level. In patients with mild renal insufficiency or normal renal function, the all-cause mortality after percutaneous coronary intervention was significantly lower than that after CABG.
  
  
  CONCLUSIONS
  Renal insufficiency is not rare in patients undergoing coronary revascularization and in the present study even mild renal insufficiency correlated with adverse clinical outcomes after revascularization. In patients with normal renal function or mild renal insufficiency, the mode of revascularization might lead to a prognostic difference.
authors.affiliation: Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, China.
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhang
authors.forename: Chang-Sheng
authors.initials: CS
authors.lastname: Ma
authors.forename: Shao-Ping
authors.initials: SP
authors.lastname: Nie
authors.forename: Xin
authors.initials: X
authors.lastname: Du
authors.forename: Qiang
authors.initials: Q
authors.lastname: Lv
authors.forename: Jun-Ping
authors.initials: JP
authors.lastname: Kang
authors.forename: Yin
authors.initials: Y
authors.lastname: Zhang
authors.forename: Rong
authors.initials: R
authors.lastname: Hu
authors.forename: Chang-Qi
authors.initials: CQ
authors.lastname: Jia
authors.forename: Xin-Min
authors.initials: XM
authors.lastname: Liu
authors.forename: Xiao-Hui
authors.initials: XH
authors.lastname: Liu
authors.forename: Jian-Zeng
authors.initials: JZ
authors.lastname: Dong
authors.forename: Fang
authors.initials: F
authors.lastname: Chen
authors.forename: Yu-Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Shu-Zheng
authors.initials: SZ
authors.lastname: Lv
authors.forename: Fang-Jiong
authors.initials: FJ
authors.lastname: Huang
authors.forename: Cheng-Xiong
authors.initials: CX
authors.lastname: Gu
authors.forename: Xue-Si
authors.initials: XS
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D003401:Creatine; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009204:Myocardial Revascularization / Q000009:adverse effects / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D051437:Renal Insufficiency / Q000150:complications / Q000401:mortality*; D020521:Stroke / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D003401:Creatine