Takuya Ogami1, Yuya Matsue2, Ryo Kawasumi1, Hiroaki Tanabe1. 1. Department of Cardiovascular Surgery, Kameda Medical Center, Chiba, Japan. 2. Department of Cardiology, Kameda Medical Center, 929, Higashi-Cho, Kamogawa, Chiba, Japan. yuya8950@gmail.com.
Abstract
PURPOSE: Chronic kidney disease (CKD) and anemia are independent preoperative risk factors for coronary artery bypass graft (CABG) surgery. We evaluated the implications of the coexistence of these two factors and their associated prognosis for CABG surgery. METHODS: We analyzed, retrospectively, consecutive patients who underwent elective CABG surgery between 2004 and 2014. The patients were classified into four groups depending on the presence or absence of preoperative CKD and anemia. We assessed the major adverse cardiac and cerebrovascular event (MACCE), defined as composite outcomes of cardio- and cerebrovascular death, revascularization through surgery or percutaneous intervention, hospitalization for congestive heart failure, and cerebral infarction. RESULTS: The study population consisted of 510 patients (73 % male; median age 71 years old), followed up for a median period of 2.8 years. Multivariate analysis indicated that neither the CKD/no-anemia group [hazard ratio (HR) 0.98, 95 % confidence interval (CI) 0.39-2.51, P = 0.973] nor the no-CKD/anemia group (HR 1.20, 95 % CI 0.69-2.09, P = 0.512) had significantly poorer prognoses than the no-CKD/no-anemia group. However, the CKD/anemia group had a significantly higher risk of a MACCE (HR 2.01, 95 % CI 1.01-3.98, P = 0.046). CONCLUSION: The presence of both CKD and anemia in patients undergoing CABG for coronary artery disease is synergistically associated with a worse outcome.
PURPOSE:Chronic kidney disease (CKD) and anemia are independent preoperative risk factors for coronary artery bypass graft (CABG) surgery. We evaluated the implications of the coexistence of these two factors and their associated prognosis for CABG surgery. METHODS: We analyzed, retrospectively, consecutive patients who underwent elective CABG surgery between 2004 and 2014. The patients were classified into four groups depending on the presence or absence of preoperative CKD and anemia. We assessed the major adverse cardiac and cerebrovascular event (MACCE), defined as composite outcomes of cardio- and cerebrovascular death, revascularization through surgery or percutaneous intervention, hospitalization for congestive heart failure, and cerebral infarction. RESULTS: The study population consisted of 510 patients (73 % male; median age 71 years old), followed up for a median period of 2.8 years. Multivariate analysis indicated that neither the CKD/no-anemia group [hazard ratio (HR) 0.98, 95 % confidence interval (CI) 0.39-2.51, P = 0.973] nor the no-CKD/anemia group (HR 1.20, 95 % CI 0.69-2.09, P = 0.512) had significantly poorer prognoses than the no-CKD/no-anemia group. However, the CKD/anemia group had a significantly higher risk of a MACCE (HR 2.01, 95 % CI 1.01-3.98, P = 0.046). CONCLUSION: The presence of both CKD and anemia in patients undergoing CABG for coronary artery disease is synergistically associated with a worse outcome.
Entities:
Keywords:
Coronary artery disease; Hemoglobin; Prognosis; Renal function
Authors: Samer A M Nashef; François Roques; Linda D Sharples; Johan Nilsson; Christopher Smith; Antony R Goldstone; Ulf Lockowandt Journal: Eur J Cardiothorac Surg Date: 2012-02-29 Impact factor: 4.191
Authors: Gregory A Wellenius; Kenneth J Mukamal; Wolfgang C Winkelmayer; Murray A Mittleman Journal: Atherosclerosis Date: 2006-08-14 Impact factor: 5.162
Authors: J D Birkmeyer; G T O'Connor; H B Quinton; M A Ricci; J R Morton; B J Leavitt; D C Charlesworth; F Hernandez; M D McDaniel Journal: J Vasc Surg Date: 1995-03 Impact factor: 4.268
Authors: Alexander Kulier; Jack Levin; Rita Moser; Gudrun Rumpold-Seitlinger; Iulia Cristina Tudor; Stephanie A Snyder-Ramos; Patrick Moehnle; Dennis T Mangano Journal: Circulation Date: 2007-07-09 Impact factor: 29.690