Prognostic Value of Renal Function for Cardiac Events in Patients Without Significant Stenosis on Coronary Computed Tomography Angiography.
This study was conducted to determine clinical parameters predicting future major adverse cardiovascular events (MACEs) in patients without significant stenosis on coronary computed tomographic angiography (CCTA). A total of 625 patients with suspected coronary artery disease (CAD) who underwent CCTA that revealed insignificant (< 50%) CAD was reviewed in three cardiac centers. The MACEs including cardiac death, non-fatal myocardial infarction (MI), unstable angina and late (> 90 days after CCTA) revascularization were assessed. During the mean follow-up period of 819 ± 529 days (median 837 days), there were 28 cases of MACEs (4.5%). In multivariable Cox regression analysis, independent predictors for MACEs were male sex (hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.01-5.69; P = 0.046) and low estimated creatinine clearance (eCCr) (< 60 mL/min/1.73 m(2)) (HR, 3.07; 95% CI, 1.22-7.74; P = 0.017). Low eCCr was the only independent predictor for hard events including cardiac death and MI (HR, 17.6, 95% CI, 1.44-215.7; P = 0.025). In conclusion, renal function is an independent predictor for cardiovascular events among patients without significant CAD by CCTA. Careful monitoring and preventive strategy are warranted in patients with impaired renal function even without significant CAD.
Division of Cardiology, Boramae Medical Center, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Hack-Lyoung
HL
Kim
Division of Cardiology, Seoul National University Hospital, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Yong-Jin
YJ
Kim
Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Yeonyee E
YE
Yoon
Division of Cardiology, Seoul National University Hospital, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Seung-Pyo
SP
Lee
Division of Cardiology, Seoul National University Hospital, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Hyung-Kwan
HK
Kim
Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Goo-Yeong
GY
Cho
Division of Cardiology, Boramae Medical Center, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Joo-Hee
JH
Zo
Division of Cardiology, Seoul National University Bundang Hospital, Seongnam, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Dong-Ju
DJ
Choi
Division of Cardiology, Seoul National University Hospital, Seoul, Korea. ; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Dae-Won
DW
Sohn
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality*; D015897:Comorbidity; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000175:diagnosis* / Q000401:mortality*; D007677:Kidney Function Tests / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*
Coronary Artery Disease; Creatinine Clearance; Multidetector Computed Tomography; Prognosis