Abstract 12919: Does Stage of Chronic Kidney Disease Predict Coronary Stenosis or Cardiovascular Event in Patients with Stable Coronary Artery Disease?
Background: Relationship between stage of chronic kidney disease (CKD) and its impact on coronary atherosclerosis remains unclear. Here we examined whether CKD stage predicts severity of coronary stenosis or major adverse cardiac events (MACE) in patients with stable coronary artery disease.
Methods: We retrospectively analyzed data from 736 consecutive patients undergoing coronary angiography for suspected stable coronary artery disease from January 2007 to December 2011. The patients were divided into three groups according to CKD stage by estimated glomerular filtration rate (eGFR): 481 patients with eGFR ≧60 ml/min (non-CKD and Stage 1), 227 patients with 30<GFR≦60 ml/min (Stage 2-3), and 28 patients with eGFR≦30 ml/min (Stage 4-5). Coronary stenosis was quantified by Gensini score (GS). MACE was defined as a composite of cardiac death, myocardial infarction, target vessel revascularization or congestive heart failure.
Results: There was no significant inter-group difference in gender, body mass index, smoking rate and prevalence of dyslipidemia, though Stage 4-5 patients was older and had higher prevalence of diabetes and hypertension compared with non-CKD/Stage 1 group. The GS was higher in more advanced stages of CKD: 27±36 in non-CKD/Stage 1, 32±34 in Stage 2-3, and 43±36 in Stage 4-5 (p<0.05). In analysis of 514 patients treated with optical medical therapy alone, MACE during 5-year follow-up tended to be higher in CKD (Stage 2-5) than in non-CKD (Figure 1A). However, incidence of MACE in patients with high GS, which was defined GS≧29, was significantly higher than in patients with low GS (Figure 1B).
Conclusion: Advancement of CKD stage associates with progression of the severity of coronary artery disease. However, severity of the stenosis, rather than stage of CKD, is as a primary predictor of long-term MACE in the patients with stable coronary artery disease.
- © 2012 by American Heart Association, Inc.