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Long-term outcomes after coronary artery bypass grafting: preoperative kidney function is prognostic

Michel B Chonchol1, Victor Aboyans, Philippe Lacroix

  • 1University of Colorado Health Sciences Center, Division of Renal Diseases and Hypertension, Denver, Colo 80262, USA. Michel.Chonchol@uchsc.edu

The Journal of Thoracic and Cardiovascular Surgery
|August 29, 2007
PubMed

Insights

Preoperative chronic kidney disease independently predicts long-term cardiovascular events and mortality after coronary artery bypass grafting. Incorporating kidney function into risk models can improve patient assessments.

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes Research

Background:

  • End-stage renal disease is a known mortality predictor post-coronary artery bypass grafting (CABG).
  • Limited data exists on the long-term impact of chronic kidney disease (CKD) on outcomes after CABG.

Purpose of the Study:

  • To assess the influence of preoperative kidney function on long-term outcomes in patients undergoing CABG.
  • To determine if CKD is an independent predictor of adverse events post-CABG.

Main Methods:

  • A cohort of 931 patients undergoing CABG was analyzed.
  • Preoperative estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation defined CKD (eGFR < 60 mL/min/1.73 m²).
  • Multivariate Cox proportional hazard analyses identified prognostic factors for a composite outcome (death, acute coronary syndrome, stroke, revascularization) and mortality.

Main Results:

  • 12.2% of patients had preoperative CKD (eGFR 20.5-59.8 mL/min/1.73 m²).
  • CKD was an independent predictor of the composite outcome (HR 1.46, P=0.0467) and overall death (HR 1.89, P=0.0106) after a mean follow-up of 3.1 years.

Conclusions:

  • Preoperative moderate-to-severe CKD independently predicts long-term cardiovascular events and total mortality after CABG.
  • CKD status should be integrated into clinical risk assessment and prediction models for CABG patients.
Abstract

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