Coronary Risk Factor Profile and Prognostic Factors for Young Japanese Patients Undergoing Coronary Revascularization

Furukawa, Yutaka; Ehara, Natsuhiko; Taniguchi, Ryoji; Haruna, Yoshisumi; Ozasa, Neiko; Saito, Naritatsu; Doi, Takahiro; Hoshino, Kozo; Tamura, Toshihiro; Shizuta, Satoshi; Abe, Mitsuru; Toma, Masanao; Morimoto, Takeshi; Teramukai, Satoshi; Fukushima, Masanori; Kita, Toru; Kimura, Takeshi; Investigators, CREDO-Kyoto

doi:10.1253/circj.cj-08-1083

Cited by 24 publications

(23 citation statements)

References 45 publications

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“…These results are consistent with previous studies, investigating the risk of GFR values estimated by the MDRD equation or by creatinine clearance among patients with cardiovascular disease. 14,15,22 This study has several limitations. First, balloon angioplasty was the sole PCI used in all patients and 51.1% of the CABG procedures involved an arterial graft.…”

Section: Discussionmentioning

confidence: 96%

“…A number of studies have reported the prognostic significance of eGFR in patients with CAD; [11][12][13][14][15][16][17][18] however, the majority of these studies were in Western countries and GFR was estimated by the MDRD equation or by creatinine clearance. Reports from Asian countries are very limited, possibly because of the lack of an accurate equation for eGFR in Asian populations.…”

Section: Discussionmentioning

confidence: 99%

“…This study is the first report describing the long-term (410 years) prognostic significance of eGFR values in patients who underwent complete coronary revascularization. There are several reports in which patients with revascularization (PCI or CABG) were assessed; [11][12][13][14][15][16][17] however, the follow-up periods in the majority of these studies were p5 years and none of them described whether complete revascularization was achieved. It is important to emphasize the benefit of assessing data only in patients who had achieved complete revascularization, because the importance of completeness of revascularization during long-term follow-up period has been reported.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, the prognostic significance of eGFR values has been studied in several subgroups such as patients with coronary artery disease (CAD), including patients who underwent percutaneous coronary intervention (PCI), [11][12][13][14] coronary artery bypass grafting (CABG) [15][16][17] or survivors of myocardial infarction. 18 However, the relationship between eGFR values and the long-term prognosis following complete coronary revascularization has not been established.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic significance of glomerular filtration rate estimated by the Japanese equation among patients who underwent complete coronary revascularization

et al. 2010

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An equation that accurately estimates the glomerular filtration rate (GFR) in the Japanese population has been proposed; however, the prognostic significance of estimated GFR (eGFR) defined according to this equation has not been reported. In addition, the prognostic significance of eGFR during long-term follow-up after complete coronary revascularization remains unclear. We assessed the prognostic significance of eGFR values, estimated by the new Japanese equation, in a cohort of patients following complete coronary revascularization. We studied consecutive patients with complete revascularization from 1984 to 1992. Patients on dialysis were excluded. A novel Japanese equation was used to estimate the GFR: eGFR¼ 194Â(serum creatinine) À1.094 Â(age) À0.287 (Â0.739 if female). Multivariate Cox proportional hazards regression analyses were performed to determine all-cause and cardiac mortality. We analyzed data of 1809 patients, of whom 571 (31.6%) had an eGFR of X90 ml min À1 per 1.73 m 2 , 917 (50.7%) had an eGFR of 60-89 ml min À1 per 1.73 m 2 , 298 (16.5%) had an eGFR of 30-59 ml min À1 per 1.73 m 2 and 23 (1.3%) had an eGFR of o30 ml min À1 per 1.73 m 2 . During follow-up (11.4 ± 2.9 years), there were 397 (22.0%) all-cause and 123 (6.8%) cardiac deaths overall. Patients with an eGFR of 30-59 ml min À1 per 1.73 m 2 , and o30 ml min À1 per 1.73 m 2 revealed significantly greater risk of all-cause mortality than those with eGFR of X90 ml min À1 per 1.73 m 2 (hazard ratio (HR) 1.91, Po0.001, HR 3.35, Po0.001, respectively). Furthermore, incidence of cardiac death was higher in patients with an eGFR of 30-59 ml min À1 per 1.73 m 2 than those with an eGFR of X90 ml min À1 per 1.73 m 2 (HR 2.89, Po0.001). GFR as estimated using the new Japanese equation had a prognostic significance among patients with complete coronary revascularization.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prognostic significance of glomerular filtration rate estimated by the Japanese equation among patients who underwent complete coronary revascularization

et al. 2010

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“…The lipid levels, such as those of LDL-C and HDL-C, are strong risk factors for the development of CVD; however, several studies have proposed that the proportion of cholesterol in each lipoprotein or the age 67) . Traditional risk factors (hyper-LDL cholesterolemia, hypo-HDL cholesterolemia, hypertension, DM and smoking) are associated with genetic predispositions and are affected by the habits of the household.…”

Section: ) Ratios Of Lipids and Apoproteinsmentioning

confidence: 99%

Cardiovascular Disease Risk Factors Other than Dyslipidemia

Teramoto

Sasaki

Ishibashi

et al. 2013

JAT

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Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention

Hirota

Sawano

Numasawa

et al. 2017

Cardiovasc Interv and Ther

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There is a growing interest in the optimizing care of acute coronary syndrome (ACS) in young patients, largely owing to their potential for longer life expectancy. Herein, we aimed to investigate the clinical characteristics and outcome of young ACS patients (e.g. under 60 year old) from a Japanese multicenter percutaneous coronary intervention (PCI) registry (KiCS-PCI). KiCS-PCI registered consecutive ACS patients from 15 institutions, and 1560 (24.0%) out of 6499 ACS-related PCI involved patients aged <60 years. In this group, prevalence of dyslipidemia, smoking and family history of premature coronary artery disease (CAD) was higher, while the other classical risk factors were lower when compared to the old patients. After adjustment for known confounders, presentation with cardiogenic shock (CS) before PCI (OR 32.57, 95% CI 12.06-87.97), culprit lesion of LMT (OR 7.53, 95% CI 1.26-44.98), multi-vessel disease (OR 3.82, 95% CI 1.37-10.63) and higher body mass index (OR 1.12, 95% CI 1.00-1.24) showed association with higher in-hospital mortality in young patients. Multi-vessel disease (OR 4.1, 95% CI 1.9-8.9) and chronic kidney disease (OR 3.56, 95% CI 2.26-5.68) were associated with CS presentation. CS presentation was inversely associated with classical risk factors such as hypertension (OR 0.61, 95% CI 0.38-0.96), family history of CAD (OR 0.49, 95% CI 0.25-0.96), and dyslipidemia (OR 0.45, 95% CI 0.29-0.71) and culprit lesion of RCA (OR 0.60, 95% CI 0.37-0.94). Overall, ACS in the younger population was observed frequently, accounting for a quarter of ACS-related PCI. CS was a harbinger for in-hospital mortality in these patients.

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Coronary Risk Factor Profile and Prognostic Factors for Young Japanese Patients Undergoing Coronary Revascularization

Cited by 24 publications

References 45 publications

Prognostic significance of glomerular filtration rate estimated by the Japanese equation among patients who underwent complete coronary revascularization

Prognostic significance of glomerular filtration rate estimated by the Japanese equation among patients who underwent complete coronary revascularization

Cardiovascular Disease Risk Factors Other than Dyslipidemia

Characteristics and in-hospital outcomes in young patients presenting with acute coronary syndrome treated by percutaneous coronary intervention

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