title: Association of low glomerular filtration rate with the incidence of stroke in patients following complete coronary revascularization.
abstract: BACKGROUND
  Low glomerular filtration rate (GFR) is associated with a worse outcome after coronary revascularization. Recently, a new specific equation to calculate the estimated GFR (eGFR) in Japanese populations has been reported, and it might be more accurate than the previously used equations. However, the relationship between a low GFR defined using the new equation for the Japanese population and the incidence of stroke following complete coronary revascularization is not yet known.
  
  
  RESULTS
  Consecutive patients who underwent complete coronary revascularization (percutaneous coronary intervention and bypass surgery) between 1984 and 1992 were enrolled. Patients on dialysis were excluded. Enrolled patients were divided into 2 groups: the preserved GFR group and the low GFR group. Low GFR was defined as eGFR<60 ml·min⁻¹·1.73 m⁻². The incidence of fatal and non-fatal stroke was compared between the groups. Among the 1,809 patients that were enrolled, 321 were placed in the low GFR group. During follow up (mean, 11.4 [2.9] years), there were 127 (7.0%) stroke events. Multivariable analysis using a Cox proportional hazards regression model revealed that the incidence of stroke was significantly higher in the low GFR group than in the preserved GFR group (hazard ratio, 1.66; 95% confidence interval, 1.10-2.48; P = 0.008).
  
  
  CONCLUSIONS
  Low GFR, defined as eGFR <60 ml·min⁻¹·1.73 m⁻², using a new specific equation for the Japanese population was associated with an increased risk of fatal and non-fatal stroke over a 10-year period after complete coronary revascularization.
authors.affiliation: Department of Cardiology, Juntendo University, School of Medicine, Juntendo University, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Konishi
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Kan
authors.initials: K
authors.lastname: Kajimoto
authors.forename: Naozumi
authors.initials: N
authors.lastname: Kubota
authors.forename: Tomotaka
authors.initials: T
authors.lastname: Dohi
authors.forename: Atsushi
authors.initials: A
authors.lastname: Amano
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D013504:Cardiovascular Surgical Procedures / Q000009:adverse effects*; D001026:Coronary Artery Bypass / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D015994:Incidence; D007564:Japan; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D020521:Stroke / Q000209:etiology*