The impact of normal range estimated glomerular filtration rate on mortality in selected patients undergoing coronary angiography – a long-term follow-up

This study evaluated the impact of the baseline estimated glomerular filtration rate (eGFR) on clinical and angiographic outcomes and long-term in-stent restenosis (ISR) rates in patients undergoing elective carotid artery stenting (CAS) procedures. Consecutive patients who underwent CAS were retrospectively enrolled (n = 456). At the end of 3 years of follow-up, patients who had died or were lost follow-up were excluded from the study and a final analysis was performed using data from the remaining 405 patients. The study population (n = 405) was divided into 3 tertiles based on the tertile values of the eGFR level (T1, T2, and T3); then, clinical and procedural characteristics and 3-year ISR rates were compared between the groups. An ISR of 50% was detected in 49 (12%) surviving patients. The 3-year ISR was higher among patients with the lowest eGFR values (T1) by 3.7 times (95% CI: 2.01-11.38) than that among patients with the highest eGFR values (T3). These significant relationships persisted following adjustment for confounders. A lower baseline eGFR level was significantly associated with an increased ISR rate. Decreased renal function may be a predictor of ISR after CAS using first-generation stents.

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Blood urea nitrogen level in patients with chronic total occlusion predicts long-term mortality independent of estimated glomerular filtration rate and serum creatine level: (9-year follow-up results)

Annals of Medical Research ◽

10.5455/annalsmedres.2020.09.1001 ◽

2021 ◽

Vol 28 (10) ◽

pp. 1801

Author(s):

Ali Ozyildiz ◽

Mustafa Cetin ◽

Savas Ozer ◽

Hakan Duman ◽

Tuncay Kiris

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Blood Urea Nitrogen ◽

Chronic Total Occlusion ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

Total Occlusion ◽

Long Term Mortality

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The impact of glomerular filtration rate estimation on cardiovascular events in elderly patients undergoing coronary angiography

European Heart Journal ◽

10.1093/eurheartj/ehab724.2908 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

A Aker ◽

A Eitan ◽

W Saliba ◽

R Jaffe ◽

B Zafrir

Keyword(s):

Glomerular Filtration Rate ◽

Coronary Angiography ◽

Elderly Patients ◽

Glomerular Filtration ◽

Kidney Function ◽

Cardiovascular Events ◽

Filtration Rate ◽

Cardiovascular Comorbidities ◽

The Impact

Abstract Objectives Estimation of kidney function by glomerular filtration rate (eGFR) is affected by age and is important for decision making regarding treatment and prognosis of patients with cardiovascular disease. We aimed to investigate the impact of eGFR on long-term cardiovascular outcomes in an elderly population undergoing coronary angiography for evaluation or treatment of coronary artery disease. Methods GFR was estimated according to Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation in 3,690 elderly patients (aged 70–100 years) undergoing coronary angiography. Patients receiving maintenance dialysis were excluded. The association between eGFR and long-term major adverse cardiovascular events (MACE) including myocardial infarction, ischemic stroke or death, was investigated. GFR was further calculated according to Modification of Diet in Renal Disease (MDRD) and the Cockroft-Gault equations, and compatibility between estimations was analyzed. Results Cardiovascular comorbidities were more prevalent with the reduction in kidney function as was the proportion of patients presenting with acute coronary syndromes. The adjusted hazard ratio (95% confidence interval) for MACE during a mean follow-up of 5 years was 0.98 (0.80–1.19), 1.05 (0.85–1.30), 1.45 (1.15–1.82), 2.20 (1.64–2.95) and 3.87 (2.28–6.58) in patients with eGFR 60–89, 45–59, 30–44, 15–29 and <15 ml/min/1.73m2, respectively, compared to eGFR >90 ml/min/1.73m2. Reclassification of eGFR stages by MDRD (upward 23.8%, downward 0.4%) and Cockroft-Gault (upward 4.3%, downward 28.1%) compared to CKD-EPI estimation, was noted. However, the association between eGFR stages and MACE was similar between equations. Conclusions Kidney function, as manifested by eGFR, has a graded inverse association with the burden of cardiovascular comorbidities and long-term adverse events in elderly patients undergoing coronary angiography. FUNDunding Acknowledgement Type of funding sources: None.

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