The association between kidney function, coronary artery disease, and clinical outcome in patients undergoing coronary angiography.
To characterize the association between chronic kidney disease (CKD), mortality, severity of coronary artery disease (CAD), treatment modality of CAD, and type of coronary stents among patients undergoing coronary angiography (CAG), we retrospectively reviewed the electronic medical records of the patients who underwent CAG at Seoul National University Bundang Hospital in Korea between May 2003 and January 2006. CKD was staged using an estimated glomerular filtration rate (eGFR) from the creatinine value prior to CAG. There were 3,637 patients included. The presence of CAD was 48% in CKD stage 1, 61% in stage 2, 73% in stage 3, 87% in stage 4, and 81% in stage 5. Survival rate gradually diminished for patients with decreasing renal function. No significant differences in all-cause and cardiac mortality were observed by medical treatment, PCI or CABG, in CKD patients with an eGFR less than 60 mL/min/1.73 m(2). CKD patients with drug-eluting stents showed significantly lower all-cause mortality (5.4% vs. 13.3%) and incidence of myocardial infarction (1.7% vs. 10%) than those with bare metal stents. In conclusion, an eGFR is a strong independent prognostic marker among patients undergoing CAG and the severity of CAD increases progressively with worsening renal function.
Na
Ki Young
KY
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Kim
Chi Weon
CW
Song
Young Rim
YR
Chin
Ho Joon
HJ
Chae
Dong-Wan
DW
D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension; D007668:Kidney / Q000473:pathology / Q000502:physiology*; D007674:Kidney Diseases / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome