Related Experiment Video
Updated: Jul 13, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Mild Renal Function Impairment and Long-Term Outcomes in Patients with Three-Vessel Coronary Artery Disease: A Cohort
Guyu Zeng1,2, Deshan Yuan1,2, Peizhi Wang1,2
1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Mild renal dysfunction in three-vessel coronary disease patients significantly increases death risk. Early screening and tailored revascularization strategies are crucial for better outcomes in these patients.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Limited data exist on long-term outcomes for patients with three-vessel coronary disease (3VD) and mild renal dysfunction (eGFR 60-89 mL/min/1.73 m2).
- Renal function is a critical factor influencing cardiovascular health and prognosis.
Purpose of the Study:
- To investigate the long-term impact of varying degrees of renal dysfunction on outcomes in patients with 3VD.
- To compare the effectiveness of different revascularization strategies (coronary artery bypass grafting vs. percutaneous coronary intervention) based on renal function.
Main Methods:
- A cohort of 5,272 patients with 3VD undergoing revascularization was analyzed.
- Patients were categorized into three groups: normal renal function (eGFR ≥90), mild renal dysfunction (eGFR 60-89), and moderate renal dysfunction (eGFR 30-59).
- Outcomes including all-cause death, cardiac death, and major adverse cardiac and cerebrovascular events (MACCE) were assessed over a median of 7.6 years.
Main Results:
- Mild and moderate renal dysfunction were associated with significantly higher risks of all-cause death compared to normal renal function (adjusted HRs 1.36 and 2.06, respectively).
- Coronary artery bypass grafting (CABG) showed better outcomes than percutaneous coronary intervention (PCI) in patients with normal and mild renal dysfunction, but this benefit was not observed in those with moderate dysfunction.
- Results remained consistent after propensity score matching.
Conclusions:
- Even mild renal impairment significantly elevates the risk of all-cause death in patients with 3VD.
- The advantage of CABG over PCI diminishes with increasing severity of renal dysfunction.
- Early screening for renal impairment in 3VD patients is recommended, alongside consideration of optimal revascularization strategies tailored to renal function.
Introduction:
Limited data are available on the long-term impact of mild renal dysfunction (estimated glomerular filtration rate [eGFR] 60-89 mL/min/1.73 m2) in patients with three-vessel coronary disease (3VD).
Methods:
A total of 5,272 patients with 3VD undergoing revascularization were included and were categorized into 3 groups: normal renal function (eGFR ≥90 mL/min/1.73 m2, n = 2,352), mild renal dysfunction (eGFR 60-89, n = 2,501), and moderate renal dysfunction (eGFR 30-59, n = 419). Primary endpoint was all-cause death. Secondary endpoints included cardiac death and major adverse cardiac and cerebrovascular events (MACCE), a composite of death, myocardial infarction, and stroke.
Results:
During the median 7.6-year follow-up period, 555 (10.5%) deaths occurred. After multivariable adjustment, patients with mild and moderate renal dysfunction had significantly higher risks of all-cause death (adjusted hazard ratio [HR]: 1.36, 95% confidence interval [CI]: 1.07-1.70; adjusted HR: 2.06, 95% CI: 1.53-2.78, respectively) compared with patients with normal renal function. Patients after coronary artery bypass grafting (CABG) had a lower rate of all-cause death and MACCE than those undergoing percutaneous coronary intervention (PCI) in the normal and mild renal dysfunction group but not in the moderate renal dysfunction group. Results were similar after propensity score matching.
Conclusions:
In patients with 3VD, even mild renal impairment was significantly associated with a higher risk of all-cause death. The superiority of CABG over PCI diminished in those with moderate renal dysfunction. Our study alerts clinicians to the early screening of mild renal impairment in patients with 3VD and provides real-world evidence on the optimal revascularization strategy in patients with renal impairment.
More Related Videos
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
10:03Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Coronary Artery Disease III: Clinical Manifestations
01:29Acute Kidney Injury III: Clinical Manifestations
01:17Factors Affecting Renal Clearance: Renal Impairment
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
01:26Coronary Artery Disease II: Pathophysiology
01:28Chronic Kidney Disease III: Interprofessional Care