Relationship between estimated glomerular filtration rate level and clinical characteristics and outcome in patients with angiographic coronary artery disease and normal serum creatinine
10.3760/cma.j.issn.0253-3758.2013.07.010
- VernacularTitle:不同肾小球滤过率冠心病患者的临床特点及其预后
- Author:
Quan LI
1
;
Yue-Chun GAO
;
Ji-Qiang HE
;
Teng-Yong JIANG
;
Xue-Jun REN
;
Fang CHEN
Author Information
1. 100029,首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所
- Keywords:
Coronary disease;
Glomerular filtration rate;
Prognosis
- From:
Chinese Journal of Cardiology
2013;41(7):563-567
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the relationship between estimated glomerular filtration rate level and clinical characteristics and outcome in coronary artery disease (CAD) patients with normal serum creatinine.Method A total of 548 hospitalized and angiographic CAD patients with normal fasting serum creatinine were enrolled.The kidney function was estimated by using the abbreviated modification of diet in renal disease (MDRD) study equation.Patients were divided into three groups according to eGFR tertiles:high eGFR group (eGFR ＞88.15 ml · min-1 · 1.73 m-2,n =184) ; intermediate group 组(70.30 ml ·min-1 · 1.73 m-2 ＜ eGFR≤88.15 ml · min-1 · 1.73 m-2,n =187) ; low eGFR group (eGFR≤70.30 ml ·min-1 · 1.73 m-2,n =177).Clinical data and cardiovascular risk factors were recorded after admission and during (14.02 ± 8.31) months follow up.The primary end point was combined major adverse cardiovascular and cerebral events (MACCE) including death,targeted vascular revascularization,non-fatal myocardial infarction,rehospitalization due to unstable angina and heart failure,and transient ischemic attack (TIA) and stroke.Results Patients in intermediate and low eGFR groups were older,more males,had more severe coronary artery disease,higher level of hsCRP,higher incidence of hypertension,and lower smoking rate than those in high eGFR group (all P ＜ 0.05).A total of 89 MACCE were recorded during follow up.The level of eGFR was significantly lower in patients with MACCE than patients without MACCE [(73.76±19.81) ml· min-1 · 1.73 m-2 vs.(84.97 ±23.42) ml· min-1 · 1.73 m-2,P＜0.05].Univariate and multivariate Cox regression analysis showed that eGFR was an independent predictor of MACCE in patients with CAD (univariate analysis:RR =0.99,95％ CI:0.973-0.997,P ＜ 0.05 ;multivariate analysis:RR =0.98,95％ CI:0.976-0.998,P ＜ 0.05).Kaplan-Meier survival analysis suggested that patients with low eGFR was linked with a decreased event free survival ratio (log-rank x2 =7.271,P ＜0.05).Conclusions eGFR level in CAD patients with normal serum creatinine is associated with coronary artery severity,inflammation level and serves as an independent predictor for MACCE in this patient cohort.
