Coronary Artery Bypass Grafting vs. Drug-Eluting Stent Implantation for Multivessel Disease in Patients with Chronic Kidney Disease

The outcomes of coronary artery bypass grafting (CABG) surgery are determined by numerous factors. This study aimed to analyze the factors contributing to short-term outcomes of patients undergoing isolated CABG. This retrospective analysis enrolled all adult patients undergoing isolated CABG at our center between January 2013 and December 2016. Clinical characteristics and postoperative events were recorded and analyzed. Overall, 242 patients (mean age, 59.7 ± 9.5 years) were included. The majority of the patients (88.4%) were men. The median left ventricular ejection fraction (LVEF) was 50% ± 15%, with 38% patients having an LVEF lower than 40% and 9.1% having an LVEF lower than 25%. The mean preoperative creatinine level was 1.25 ± 0.73, and the estimated glomerular filtration rate was 68.55 ± 23 ml/min/1.73 m2. The intensive cardiac care unit stay and total in-hospital stay were 70 ± 59 h and 8 ± 4 days, respectively. The in-hospital mortality rate was 2.1%. The most common major adverse events were new-onset atrial fibrillation (31.8%) and significant worsening of renal function (21.5%). Stroke occurred in 3.7% patients, for which preexisting chronic kidney disease (CKD) and dyslipidemia were strong predictors (P < 0.05; area under the curve [AUC], 87.7%). Advanced age and hypertension were considered significant risk factors for developing new-onset atrial fibrillation (P < 0.05; AUC 65%). Worsening renal function and new-onset atrial fibrillation were the most frequent complications that occurred during hospitalization following CABG. Preexisting CKD and dyslipidemia were the major risk factors for developing acute stroke post surgery. KEYWORDS Acute cerebrovascular events, Chronic kidney disease, Coronary artery bypass grafting, Dyslipidemia.

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Comparison of Outcomes of Coronary Artery Bypass Grafting Versus Drug-Eluting Stent Implantation in Patients With Severe Left Ventricular Dysfunction

The American Journal of Cardiology ◽

10.1016/j.amjcard.2017.03.261 ◽

2017 ◽

Vol 120 (1) ◽

pp. 69-74 ◽

Cited By ~ 16

Author(s):

Se Hun Kang ◽

Cheol Whan Lee ◽

Seunghee Baek ◽

Pil Hyung Lee ◽

Jung-Min Ahn ◽

...

Keyword(s):

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Stent Implantation ◽

Ventricular Dysfunction ◽

Artery Bypass ◽

Left Ventricular ◽

Drug Eluting Stent ◽

Bypass Grafting ◽

Severe Left Ventricular Dysfunction ◽

Drug Eluting

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THE IMPACT OF DIALYSIS DEPENDENCE AND DIALYSIS DURATION OF CHRONIC KIDNEY DISEASE ON OUTCOMES AFTER CORONARY ARTERY BYPASS GRAFTING: A NATIONWIDE COHORT STUDY IN ASIA

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(16)30183-8 ◽

2016 ◽

Vol 67 (13) ◽

pp. 182

Author(s):

Tien Hsing Chen

Keyword(s):

Chronic Kidney Disease ◽

Cohort Study ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Kidney Disease ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Bypass Grafting ◽

Dialysis Duration ◽

The Impact

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Serum and tissue endothelin-1 are independent from intima-media thickness of peripheral arteries in patients with chronic kidney disease

Vascular ◽

10.1177/1708538114551195 ◽

2014 ◽

Vol 23 (4) ◽

pp. 382-390 ◽

Cited By ~ 3

Author(s):

Nariman Nezami ◽

Nariman Sepehrvand ◽

Mohammad Mirchi ◽

Behzad Salari ◽

Behrooz Shokouhi ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Coronary Artery ◽

Coronary Artery Bypass Grafting ◽

Kidney Disease ◽

Coronary Artery Bypass ◽

Artery Bypass ◽

Intima Media Thickness ◽

Bypass Grafting ◽

Endothelin 1 ◽

Media Thickness

AimWe aimed to study the relationship of peripheral arteries’ atherosclerosis with serum and tissue endothelin-1 in chronic kidney disease patients.MethodsNinety patients were enrolled, including 35 patients with chronic kidney disease (case group), 31 patients with coronary artery diseases who were candidates for coronary artery bypass grafting (positive control group), and 24 living kidney donors (negative control group). Intima-media thickness of the common carotid and femoral arteries was determined by ultrasonography. Serum and tissue endothelin-1 were measured by ELISA method.ResultsThe mean serum and tissue endothelin-1 levels in the donor group were significantly lower than other groups ( p < 0.001 for both). The coronary artery bypass grafting group had higher carotid and femoral intima-media thickness than other groups ( p < 0.001), and the chronic kidney disease group had higher carotid and femoral intima-media thickness than the donor group ( p < 0.001). Regression analysis in all groups did not reveal any correlation between the carotid intima-media thickness/femoral intima-media thickness and the serum/tissue endothelin-1. There was a direct linear correlation between the carotid and femoral intima-media thickness ( p < 0.001) in all groups.ConclusionsEndothelin-1 level and intima-media thickness were higher in the chronic kidney disease patients and coronary artery bypass grafting candidates, without any correlation between endothelin-1 and peripheral arteries’ intima-media thickness of both groups. Perhaps endothelin-1 rises and remains high upon endothelial damage and initiation of atherosclerosis.

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