Increased arterial stiffness after coronary artery revascularization correlates with serious coronary artery lesions and poor clinical outcomes in patients with chronic kidney disease.
OBJECTIVE
This study aimed to clarify the relationship between arterial stiffness and coronary artery lesions as well as their influence on long-term outcomes after coronary artery revascularization in patients with chronic kidney disease (CKD).


METHODS
A total of 205 patients who had a coronary angiography and received coronary artery revascularization on demand were enrolled and followed up for 5 years. Demographic and clinical indicators, arterial stiffness indexes, angiographic characteristics and the Gensini score (GS) were recorded at baseline. Major adverse cardiac events (MACE), including cardiac death and repeat coronary artery revascularization, that occurred during the 5 years of follow-up were also recorded.


RESULTS
All indexes reflecting the degree of arterial stiffness, including PWV, C1, C2, CSBP, CDBP, AP and Aix, were significantly higher in CKD than in non-CKD patients (all p < 0.05). Patients with CKD also had a higher rate of coronary artery disease and a higher GS (p < 0.05 and p < 0.01, respectively). Logistic regression analysis revealed CKD to be an independent risk factor for increased arterial stiffness (OR = 2.508, 95% CI 1.308-4.808, p = 0.006). During follow-up, CKD patients with PWV >13 m/s or Aix@75 >30 had a significantly higher MACE occurrence rate after coronary artery revascularization (both p < 0.05).


CONCLUSIONS
These results highlight that CKD and arterial stiffness correlate with the severity of coronary artery lesions. CKD patients with impaired arterial stiffness have poor clinical outcomes, suggesting a further clinical use of the arterial stiffness index as a surrogate of worse cardiovascular prognosis in CKD than in non-CKD patients.
Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zhengbin
Z
Zhu
Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Zijun
Z
Yan
Department of Civil Aviation Administration of China (CAAC), East China Regional Administration Aviation Personnel Examination Center, Shanghai Hospital of Civil Aviation, Shanghai, China.
Lin
L
Zhang
Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Run
R
Du
Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Jinzhou
J
Zhu
Department of Hypertension, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Junli
J
Zuo
Department of Hypertension, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shaoli
S
Chu
Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Weifeng
W
Shen
Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Ruiyan
R
Zhang
Arterial stiffness; Chronic kidney disease; Coronary artery disease; Prognosis