Key result
Chronic kidney disease increased the risk of major adverse cardiac events by 71% (HR 1.71) compared to preserved renal function in patients with coronary artery disease, an effect driven by those with ventricular dysfunction.
Why the study?
The role of CKD in the long-term prognosis of CAD patients was unknown, and the study investigated whether CKD affects ventricular function.
Does chronic kidney disease worsen long-term prognosis in patients with coronary artery disease and ventricular dysfunction?
Observational (n=918)
No
Does chronic kidney disease worsen long-term prognosis in patients with coronary artery disease and ventricular dysfunction?
Hazard Ratio: 1.71 (95% CI 1.26–2.31)
Absolute Event Rate: 21.1% vs 18%
p-value: p=<0.001
Chronic kidney disease is associated with significantly higher mortality in coronary artery disease patients with left ventricular dysfunction, but does not appear to worsen prognosis when ventricular function is preserved.
A strong association exists between chronic kidney disease (CKD) and coronary artery disease (CAD). The role of CKD in the long-term prognosis of CAD patients with versus those without CKD is unknown. This study investigated whether CKD affects ventricular function.From January 2009 to January 2010, 918 consecutive patients were selected from an outpatient database. Patients had undergone percutaneous, surgical, or clinical treatment and were followed until May 2015.In patients with preserved renal function (n = 405), 73 events (18%) occurred, but 108 events (21.1%) occurred among those with CKD (n = 513) (P < .001). Regarding left ventricular ejection fraction (LVEF) <50%, we found 84 events (21.5%) in CKD patients and 12 (11.8%) in those with preserved renal function (P < .001). The presence of LVEF <50% brought about a modification effect. Death occurred in 22 (5.4%) patients with preserved renal function and in 73 (14.2%) with CKD (P < .001). In subjects with LVEF <50%, 66 deaths (16.9%) occurred in CKD patients and 7 (6.9%) in those with preserved renal function (P = .001). No differences were found in CKD strata regarding events or overall death among those with preserved LVEF. In a multivariate model, creatinine clearance remained an independent predictor of death (P < .001).We found no deleterious effects of CKD in patients with CAD when ventricular function was preserved. However, there was a worse prognosis in patients with CKD and ventricular dysfunction.Resgistry number is ISRCTN17786790 at https://doi.org/10.1186/ISRCTN17786790.
No takes yet. Share an insight, caveat, or question.
Hueb et al. (2019) conducted an observational in Coronary artery disease (n=918). Chronic kidney disease vs. Preserved renal function was evaluated on Major adverse cardiac events (MACE) (HR 1.71, 95% CI 1.26-2.31, p=<0.001). Chronic kidney disease increased the risk of major adverse cardiac events by 71% (HR 1.71) compared to preserved renal function in patients with coronary artery disease, an effect driven by those with ventricular dysfunction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: