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[The impact of renal function on clinical outcomes of patients without chronic kidney disease undergoing coronary

Qiang Zhang1, Chang-Sheng Ma, Shao-Ping Nie

  • 1Department of Cardiology, Beijing Anzhen Hospital, Capital University of Medical Sciences, Beijing 100029, China.

Zhonghua Nei Ke Za Zhi
|December 17, 2008
PubMed

Insights

Renal insufficiency, even mild, is common in patients undergoing coronary revascularization and linked to worse outcomes. Choosing the right revascularization method may improve prognosis for those with normal or mild renal insufficiency.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Outcomes

Context:

  • Coronary revascularization procedures carry risks, particularly for patients with pre-existing renal conditions.
  • Understanding the impact of renal function on outcomes is crucial for patient management.

Purpose:

  • To determine the prevalence of renal insufficiency in patients undergoing coronary revascularization.
  • To analyze the effect of varying degrees of renal insufficiency on clinical outcomes.
  • To investigate if the choice of revascularization strategy influences prognosis.

Summary:

  • A study of 2896 patients found renal insufficiency common, with mild cases (CrCl 60-90 ml/min) showing increased in-hospital mortality and major adverse cardiac and cerebral events (MACCE).
  • Both in-hospital and follow-up periods revealed significant differences in mortality, stroke, and MACCE across renal function groups.
  • Independent risk factors for death included revascularization mode, age, and creatinine clearance (CrCl) level.

Impact:

  • Even mild renal insufficiency is associated with adverse clinical outcomes post-revascularization.
  • For patients with normal or mild renal insufficiency, the choice between percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) may impact prognosis, with PCI showing lower mortality.
Abstract

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