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Renal function and coronary bypass surgery in patients with ischemic heart failure

Torsten Doenst1, Haissam Haddad2, Amanda Stebbins3

  • 1Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany.

The Journal of Thoracic and Cardiovascular Surgery
|May 11, 2020
PubMed

Insights

Chronic kidney disease (CKD) increases mortality risk in ischemic heart failure patients. However, mild to moderate CKD does not affect the long-term benefits of coronary artery bypass grafting (CABG).

Area of Science:

  • Cardiology
  • Nephrology
  • Surgical Outcomes

Background:

  • Chronic kidney disease (CKD) is a known cardiovascular disease risk factor.
  • The impact of CKD on coronary artery bypass grafting (CABG) outcomes is not fully understood.

Purpose of the Study:

  • To assess how CKD influences 10-year mortality and cardiovascular outcomes.
  • To evaluate the effect of CKD on patients with ischemic heart failure treated with medical therapy or CABG.

Main Methods:

  • Calculated estimated glomerular filtration rate (eGFR) for 1209 patients in the Surgical Treatment for IsChemic Heart failure trial.
  • Assessed the impact of CKD stages (1-5) on mortality and cardiovascular events in patients randomized to medical treatment or CABG.

Main Results:

  • Lower eGFR (indicating CKD) was associated with increased risk of death, cardiovascular death, and rehospitalization (P < .001).
  • CABG significantly improved outcomes (death or cardiovascular rehospitalization) in CKD stages 1-3.
  • No significant interaction was found between eGFR and CABG treatment effect (P > .25).

Conclusions:

  • CKD is an independent risk factor for mortality in ischemic heart failure patients.
  • Mild to moderate CKD does not alter the long-term effectiveness of CABG.
Abstract

Keywords:
CABG treatment effectchronic kidney diseasecoronary artery bypass graftingmedical therapysurvival

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