J Korean Med Sci.  2009 Jan;24(Suppl 1):S87-S94. 10.3346/jkms.2009.24.S1.S87.

The Association between Kidney Function, Coronary Artery Disease, and Clinical Outcome in Patients Undergoing Coronary Angiography

• Na KY
• Kim CW
• Song YR
• Chin HJ
• Chae DW

• KMID: 1778146
• DOI: http://doi.org/10.3346/jkms.2009.24.S1.S87

Abstract

To characterize the association between chronic kidney disease (CKD), mortality, severity of coronary artery disease (CAD), treatment modality of CAD, and type of coronary stents among patients undergoing coronary angiography (CAG), we retrospectively reviewed the electronic medical records of the patients who underwent CAG at Seoul National University Bundang Hospital in Korea between May 2003 and January 2006. CKD was staged using an estimated glomerular filtration rate (eGFR) from the creatinine value prior to CAG. There were 3,637 patients included. The presence of CAD was 48% in CKD stage 1, 61% in stage 2, 73% in stage 3, 87% in stage 4, and 81% in stage 5. Survival rate gradually diminished for patients with decreasing renal function. No significant differences in all-cause and cardiac mortality were observed by medical treatment, PCI or CABG, in CKD patients with an eGFR less than 60 mL/min/1.73 m(2). CKD patients with drug-eluting stents showed significantly lower all-cause mortality (5.4% vs. 13.3%) and incidence of myocardial infarction (1.7% vs. 10%) than those with bare metal stents. In conclusion, an eGFR is a strong independent prognostic marker among patients undergoing CAG and the severity of CAD increases progressively with worsening renal function.

Keyword

Kidney Failure, Chronic; Coronary Angiography; Coronary Artery Disease; Mortality; Drug-eluting Stents

MeSH Terms

Aged
Coronary Angiography/*methods
Coronary Artery Disease/complications/*diagnosis/mortality
Female
Glomerular Filtration Rate
Humans
Hypertension
Kidney/pathology/*physiology
Kidney Diseases/complications/*diagnosis/mortality
Kidney Function Tests
Male
Middle Aged
Stents
Time Factors
Treatment Outcome

Figure

• 

  Fig. 1 Kaplan-Meier survival curves for all-cause mortality by chronic kidney disease (CKD) stages.

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