Does Mild Renal Failure Affect Coronary Flow Reserve after Coronary Artery Bypass Graft Surgery?

Gülbaran, Murat; Çiftçi, Özgür; Çalışkan, Mustafa; Özülkü, Mehmet; Bingöl, Hakan; Körez, Muslu Kazım; Aşlamacı, Sait

doi:10.1532/hsf98.2013272

Cited by 6 publications

(9 citation statements)

References 27 publications

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“…In our study, all patients' age is greater than 65 years old. However, the age, as a HR for long-term mortality, shows no difference with other studies [ 7 , 9 - 12 ] .…”

Section: Discussioncontrasting

confidence: 68%

“…Garg et al [ 12 ] report had proved that off-pump or on-pump CABG surgery had no significant difference in the loss of kidney function within 1 year. Why mild preoperative RI decreased long-term mortality after CABG surgery is still being investigated.…”

Section: Discussionmentioning

confidence: 99%

“…Why mild preoperative RI decreased long-term mortality after CABG surgery is still being investigated. Recently, Günday et al [ 12 ] reported that patients with mild preoperative RI have a significantly lower mean coronary flow reserve after CABG surgery compared with normal preoperative renal function (2.09±0.08 vs. 2.37±0.06, P <0.05). Then they concluded that mild RI can produce adverse effects due to deterioration of the microvascular bed.…”

Section: Discussionmentioning

confidence: 99%

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Outcomes Following Coronary Artery Bypass Graft Surgery in Patients with Mild Preoperative Renal Insufficiency

Wang¹,

Wang²,

Xu³

et al. 2018

Braz J Cardiovasc Surg

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IntroductionPreoperative renal insufficiency is an independent predictor of mortality after coronary artery bypass graft (CABG) surgery. However, there are few reports aimed to evaluate the impact of mild preoperative renal insufficiency on long-term follow-up outcomes after isolated CABG surgery. This study investigates the effect of mild preoperative renal insufficiency on long-term follow-up outcomes of patients after CABG.MethodsFive hundred eighty-four patients' data that underwent CABG between 1 January 2009 and 1 December 2016 were retrospectively analyzed. They were divided into two groups: normal group [Estimated glomerular filtration rate (eGFR) ≥ 90 ml/min/1.73 m2, n=304] and mild group (eGFR ranges from 60 to 89 ml/min/1.73 m2, n=280). Clinical material and long follow-up outcomes were compared inthe two groups.ResultsTwo groups had similar baseline and intraoperative data except eGFR. Six (0.01%) patients died in hospital, 15 in normal group and 28 in mild group during the long-term follow-up, which had statistical significance (P<0.05). Univariate factor analysis displayed that the two groups had similar in-hospital outcomes. Kaplan-Meier curves showed a better long-term survival in patients with normal preoperative renal function compared to mild preoperative renal insufficiency (x 2=4.255, P=0.039). Cox proportional model presented the hazard ratio of long-term mortality in patients with mild preoperative renal insufficiency compared to normal preoperative renal function was 1.79 (95% CI 1.17-2.88, P=0.027).ConclusionsPatients with mild preoperative renal insufficiency had a higher mortality rate than normal patients in long-term survival, whereas no evidence of worse in-hospital mortality rate was found. Patients with mild preoperative renal insufficiency showed a higher mortality rate than other studies.

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“…In our study, all patients' age is greater than 65 years old. However, the age, as a HR for long-term mortality, shows no difference with other studies [ 7 , 9 - 12 ] .…”

Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Outcomes Following Coronary Artery Bypass Graft Surgery in Patients with Mild Preoperative Renal Insufficiency

Wang¹,

Wang²,

Xu³

et al. 2018

Braz J Cardiovasc Surg

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“…The reason why mild preoperative renal insufficiency decreasing long-term mortality after isolated OPCAB surgery deserved to be further studied. Recently, Günday and colleagues [ 20 ] conducted a study included 52 consecutive patients with mild preoperative renal dysfunction vs. normal preoperative renal function undergoing uncomplicated CABG surgery, with respect to coronary flow reserve measured by a second harmonic trans-thoracic Doppler echocardiography. They found that although there was a significant increase in the mean coronary flow reserve after CABG surgery compared with baseline coronary flow reserve, patients with mild preoperative renal insufficiency compared with normal preoperative renal function have a significantly lower mean coronary flow reserve after CABG surgery (2.09 ± 0.08 vs. 2.37 ± 0.06, p < 0.05).…”

Section: Discussionmentioning

confidence: 99%

Impact of mild preoperative renal insufficiency on in-hospital and long-term outcomes after off-pump coronary artery bypass grafting: a retrospective propensity score matching analysis

Xia

Shi

et al. 2016

J Cardiothorac Surg

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BackgroundMild preoperative renal insufficiency is not rare in patients receiving isolated off-pump coronary artery bypass grafting surgery (OPCAB) surgery. However, there is less study aimed to evaluate the impact of mild preoperative renal insufficiency on in-hospital and follow-up outcomes after isolated OPCAB surgery. This single-centre, retrospective propensity score matching study aimed to evaluate the impact of mild preoperative renal insufficiency on in-hospital and long-term outcomes after first isolated OPCAB surgery.MethodsAfter propensity score matching, 1236 patients with preoperative estimated glomerular filtration rate (eGFR) of more than 60 ml/min/1.73 m2 undergoing first isolated OPCAB surgery from January 2007 to December 2011 were entered into this study and were divided to normal group (eGFR ≥ 90 ml/min/1.73 m2, n = 618) and mild group (eGFR of 60–89 ml/min/1.73 m2, n = 618). The in-hospital and long-term outcomes were investigated and retrospectively analyzed.ResultsThe 2 propensity score-matched groups had similar baseline and procedural characteristics except the baseline eGFR. Thirty-five patients died during the same hospitalization or within 30 days of operation, with a surgical mortality of 2.8 %. Sixty-seven patients died during follow-up, with a long-term survival of 94.1 %. Univariate factor analysis showed that the 2 propensity score-matched groups have similar rates among in-hospital outcomes. Kaplan-Meier curves displayed a similar in-hospital survival between the 2 groups (χ2 = 0.728, p = 0.393), while a better long-term survival in patients with normal preoperative renal function compared with mild preoperative renal insufficiency (χ2 = 4.722, p = 0.030). After Cox proportional model was used, the hazard ratio for long-term mortality in patients with mild preoperative renal insufficiency compared with normal preoperative renal function was 1.72 (95 % CI 1.06–2.83, p = 0.032).ConclusionsMild preoperative renal insufficiency compared with normal preoperative renal function reduced long-term survival, without evidence of worse in-hospital outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-016-0422-2) contains supplementary material, which is available to authorized users.

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“…Also well established have been significant correlations between mildly impaired renal function and coronary heart disease prognosis, [10] severity of coronary lesions, [11] and reduced coronary flow reserve in patients who have undergone coronary artery bypass grafting surgery. [12] Several equations employing creatinine levels have been used to estimate glomerular filtration rate (GFR). The Cockroft-Gault and Modification of Diet in Renal Disease (MDRD) equations have been widely used for this purpose.…”

mentioning

confidence: 99%

Is there a relationship between slow coronary flow and normal to mildly impaired renal function?

Çabuk¹,

Çabuk

Karamanlıoğlu³

et al. 2016

Arch Turk Soc Cardiol

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Objective: The Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is more effective at estimating glomerular filtration rate (GFR) than the Modification of Diet in Renal Disease (MDRD) equation, particularly in patients with mildly impaired renal function. Recent studies have demonstrated, using the Cockroft-Gault and MDRD formulas, a significant correlation between slow coronary flow (SCF) and normal to mildly impaired renal function. However, these studies had some limitations. The aim of the present study was to investigate the relationship between SCF and normal to mildly impaired renal function using the CKD-EPI equation.Methods: A total of 370 patients were included, 172 with normal coronary flow (NCF) and 198 with SCF. All participants had normal to mildly impaired renal function. Both the CKD-EPI and MDRD formulas were used to calculated estimated glomerular filtration rate (eGFR), which was compared between groups. Results

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Does Mild Renal Failure Affect Coronary Flow Reserve after Coronary Artery Bypass Graft Surgery?

Abstract: In our study, we detected a decrease in CFR in patients with mild renal failure. We believe that in patients undergoing CABG for coronary artery disease, mild renal failure can produce adverse effects due to deterioration of the microvascular bed.

Cited by 6 publications

References 27 publications

Outcomes Following Coronary Artery Bypass Graft Surgery in Patients with Mild Preoperative Renal Insufficiency

Outcomes Following Coronary Artery Bypass Graft Surgery in Patients with Mild Preoperative Renal Insufficiency

Impact of mild preoperative renal insufficiency on in-hospital and long-term outcomes after off-pump coronary artery bypass grafting: a retrospective propensity score matching analysis

Is there a relationship between slow coronary flow and normal to mildly impaired renal function?

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