Impact of chronic kidney disease on left main coronary artery disease and prognosis in Japanese patients

Kazuhiro Dan, Toru Miyoshi, Masayuki Ueeda, Hiroaki Ohtsuka, Satoko Ugawa, Nobuhiko Ohnishi, Atsushi Takaishi, Kazufumi Nakamura, Kengo Kusano, Hiroshi Ito

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: Renal insufficiency plays a critical role in the pathogenesis of ischemic heart disease. The aim of the present study was to investigate the prevalence of renal dysfunction and its impact on prognosis in patients with left main coronary artery disease (LMCAD) and stable angina pectoris. Methods and Results: A total of 626 consecutive patients with significant coronary artery stenosis were enrolled. Renal insufficiency was graded using estimated glomerular filtration rate (eGFR) before coronary angiography. Chronic kidney disease (CKD) was defined as eGFR <60 ml · min-1 · 1.73 m-2 and/or proteinuria. Patients with LMCAD (n=95) had a significantly higher prevalence of CKD than those without LMCAD (P=0.02). Multiple logistic regression analysis showed that CKD was independently associated with LMCAD (adjusted odds ratio, 1.74; 95% confidence interval [CI]: 1.09-2.76, P=0.01). A 1-year follow-up of patients with LMCAD showed that the cumulative incidence of major adverse cardiovascular events among patients with eGFR <30 ml · min-1 · 1.73 m-2 was higher than that among patients with eGFR ≥60 ml · min-1 · 1.73 m-2 (P=0.03). The hazard ratio for a cardiovascular event was 9.54 (95% CI: 3.15-28.89, P<0.01) when comparing patients with LMCAD and eGFR <30 ml · min-1 · 1.73 m-2 vs. patients without LMCAD and eGFR ≥60 ml · min-1 · 1.73 m-2. Conclusions: Renal insufficiency is a risk factor for LMCAD and predicts poor prognosis in Japanese patients.

Original languageEnglish
Pages (from-to)2266-2272
Number of pages7
JournalCirculation Journal
Volume76
Issue number9
DOIs
Publication statusPublished - Sep 3 2012

Keywords

  • Chronic kidney disease
  • Coronary artery disease
  • Left main coronary artery
  • Risk factor

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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