Zhengbin Zhu1, Zijun Yan1, Lin Zhang2, Run Du1, Jinzhou Zhu1, Junli Zuo3, Shaoli Chu3, Weifeng Shen1, Ruiyan Zhang1. 1. Department of Cardiology, Shanghai Jiao Tong University School of Medicine, Shanghai, China. 2. Department of Civil Aviation Administration of China (CAAC), East China Regional Administration Aviation Personnel Examination Center, Shanghai Hospital of Civil Aviation, Shanghai, China. 3. Department of Hypertension, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Abstract
OBJECTIVES: 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). CONCLUSION: 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.
OBJECTIVES: 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-CKDpatients (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, CKDpatients with PWV >13 m/s or Aix@75 >30 had a significantly higher MACE occurrence rate after coronary artery revascularization (both p < 0.05). CONCLUSION: These results highlight that CKD and arterial stiffness correlate with the severity of coronary artery lesions. CKDpatients 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-CKDpatients.
Authors: Marcello Tonelli; Paul Muntner; Anita Lloyd; Braden J Manns; Scott Klarenbach; Neesh Pannu; Matthew T James; Brenda R Hemmelgarn Journal: Lancet Date: 2012-06-19 Impact factor: 79.321
Authors: Lesley A Inker; Brad C Astor; Chester H Fox; Tamara Isakova; James P Lash; Carmen A Peralta; Manjula Kurella Tamura; Harold I Feldman Journal: Am J Kidney Dis Date: 2014-03-16 Impact factor: 8.860