Increased Arterial Stiffness after Coronary Artery Revascularization Correlates with Serious Coronary Artery Lesions and Poor Clinical Outcomes in Patients with Chronic Kidney Disease

Abstract

Objectives: This study aimed to clarify the relationship between arterial stiffness and coronary artery lesions as well as their influence on long-term outcomes after coronary artery revascularization in patients with chronic kidney disease (CKD). Methods: A total of 205 patients who had a coronary angiography and received coronary artery revascularization on demand were enrolled and followed up for 5 years. Demographic and clinical indicators, arterial stiffness indexes, angiographic characteristics and the Gensini score (GS) were recorded at baseline. Major adverse cardiac events (MACE), including cardiac death and repeat coronary artery revascularization, that occurred during the 5 years of follow-up were also recorded. Results: All indexes reflecting the degree of arterial stiffness, including PWV, C1, C2, CSBP, CDBP, AP and Aix, were significantly higher in CKD than in non-CKD patients (all p < 0.05). Patients with CKD also had a higher rate of coronary artery disease and a higher GS (p < 0.05 and p < 0.01, respectively). Logistic regression analysis revealed CKD to be an independent risk factor for increased arterial stiffness (OR = 2.508, 95% CI 1.308-4.808, p = 0.006). During follow-up, CKD patients with PWV >13 m/s or Aix@75 >30 had a significantly higher MACE occurrence rate after coronary artery revascularization (both p < 0.05). Conclusion: These results highlight that CKD and arterial stiffness correlate with the severity of coronary artery lesions. CKD patients with impaired arterial stiffness have poor clinical outcomes, suggesting a further clinical use of the arterial stiffness index as a surrogate of worse cardiovascular prognosis in CKD than in non-CKD patients. i 2014 S. Karger AG, Basel

The role of non-invasive Arterial Stiffness diagnostics in perioperative risk stratification for CABG

“…A handful of studies have proposed AS as a predictor of adverse cardiac outcomes in chronic medically managed CAD (30,33,(35)(36)(37). In addition to greater risk of long-term cardiac events, one study found AS to be a predictor of future percutaneous intervention (PCI) or CABG.…”

Marcadores no invasivos de aterosclerosis en pacientes con isquemia crítica de las extremidades inferiores

“…En una línea similar, el grupo de Zhu et al demostró cómo una mayor rigidez arterial se asoció a peor pronóstico en pacientes con enfermedad crónica sometidos a revascularización coronaria, con una mayor incidencia de eventos cardiacos adversos incluyendo muerte cardiaca y necesidad de nueva revascularización coronaria. (106)(107) A la vista de estos resultados, la rigidez arterial puede ser un componente significativo en el mayor riesgo cardiovascular que se asocia al fallo renal, explicando la mayor morbimortalidad de origen cardiovascular que presentan los enfermos renales y por ende, los pacientes con isquemia crítica que asocian insuficiencia renal, y sugiriendo la utilización de la VOP.…”