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Áhrif skertrar nýrnastarfsemi á snemmkominn árangur kransæðahjáveituaðgerða

Sveinsdottir, Nanna ; Heidarsdottir, Sunna Run ; Steinthorsson, Arni Steinn ; Johannesdottir, Hera LU ; Heimisdottir, Alexandra Aldis ; Kristjansson, Tomas Thor ; Einarsson Long, Thorir LU ; Gudmundsdottir, Ingibjorg ; Sigurdsson, Martin Ingi and Gudbjartsson, Tomas (2022) In Laeknabladid 108(5). p.231-237
Abstract

INTRODUCTION: Impaired renal function as seen in chronic kidney disease (CKD) is a known risk factor for coronary artery diseases and has been linked to inferior outcome after myocardial revascularization. Studies on the outcome of coronary bypass grafting (CABG) in CKD-patients are scarce. We aimed to study this subgroup of patients following CABG in a well defined whole-nation cohort, focusing on short term complications and 30 day mortality.

MATERIALS AND METHODS: A retrospective study on 2300 consecutive patients that underwent CABG at Landspítali University Hospital 2001-2020. Patients were divided into four groups according to preoperative estimated glomerular filtration rate (GFR), and the groups compared. GFR 45-59... (More)

INTRODUCTION: Impaired renal function as seen in chronic kidney disease (CKD) is a known risk factor for coronary artery diseases and has been linked to inferior outcome after myocardial revascularization. Studies on the outcome of coronary bypass grafting (CABG) in CKD-patients are scarce. We aimed to study this subgroup of patients following CABG in a well defined whole-nation cohort, focusing on short term complications and 30 day mortality.

MATERIALS AND METHODS: A retrospective study on 2300 consecutive patients that underwent CABG at Landspítali University Hospital 2001-2020. Patients were divided into four groups according to preoperative estimated glomerular filtration rate (GFR), and the groups compared. GFR 45-59 mL/mín/1.73m2, GFR 30-44 mL/mín/1.73m2, GFR <30 mL/mín/1.73m2 and controls with normal GFR (≥60 mL/mín/1.73m2). Clinical information was gathered from medical records and logistic regression used to estimate risk factors of 30-day mortality.

RESULTS: Altogether 429 (18.7%) patients had impaired kidney function; these patients being more than six years older, having more cardiac symptoms and a higher mean EuroSCORE II (5.0 vs. 1.9, p<0.001) compared to controls. Furthermore, their left ventricular ejection fraction was also lower, their median hospital stay extended by two days and major short-term complications more common, as was 30 day mortality (24.4% vs. 1.4%, p<0.001). In multivariate analysis advanced age, ejection fraction <30% and GFR <30 mL/min/1.73m2 were independent predictors of higher 30-day mortality (OR=10.4; 95% CI: 3.98-25.46).

CONCLUSIONS: Patients with impaired renal function are older and more often have severe coronary artery disease. Early complications and 30-day mortality were much higher in these patients compared to controls and advanced renal failure and the strongest predictor of 30-day mortality.

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author
; ; ; ; ; ; ; ; and
alternative title
Impact of renal dysfunction on early outcomes of coronary artery bypass grafting surgery
publishing date
type
Contribution to journal
publication status
published
keywords
Coronary Artery Bypass/adverse effects, Coronary Artery Disease/complications, Female, Humans, Male, Renal Insufficiency/complications, Renal Insufficiency, Chronic/complications, Retrospective Studies, Stroke Volume, Ventricular Function, Left
in
Laeknabladid
volume
108
issue
5
pages
231 - 237
publisher
Icelandic Medical Association
external identifiers
  • scopus:85129781349
  • pmid:35499246
ISSN
0023-7213
DOI
10.17992/lbl.2022.05.690
language
Icelandic
LU publication?
no
id
c5be8bca-a8ff-42f8-a1fb-3de91ba24188
date added to LUP
2024-12-06 14:52:17
date last changed
2025-06-07 18:39:33
@article{c5be8bca-a8ff-42f8-a1fb-3de91ba24188,
  abstract     = {{<p>INTRODUCTION: Impaired renal function as seen in chronic kidney disease (CKD) is a known risk factor for coronary artery diseases and has been linked to inferior outcome after myocardial revascularization. Studies on the outcome of coronary bypass grafting (CABG) in CKD-patients are scarce. We aimed to study this subgroup of patients following CABG in a well defined whole-nation cohort, focusing on short term complications and 30 day mortality.</p><p>MATERIALS AND METHODS: A retrospective study on 2300 consecutive patients that underwent CABG at Landspítali University Hospital 2001-2020. Patients were divided into four groups according to preoperative estimated glomerular filtration rate (GFR), and the groups compared. GFR 45-59 mL/mín/1.73m2, GFR 30-44 mL/mín/1.73m2, GFR &lt;30 mL/mín/1.73m2 and controls with normal GFR (≥60 mL/mín/1.73m2). Clinical information was gathered from medical records and logistic regression used to estimate risk factors of 30-day mortality.</p><p>RESULTS: Altogether 429 (18.7%) patients had impaired kidney function; these patients being more than six years older, having more cardiac symptoms and a higher mean EuroSCORE II (5.0 vs. 1.9, p&lt;0.001) compared to controls. Furthermore, their left ventricular ejection fraction was also lower, their median hospital stay extended by two days and major short-term complications more common, as was 30 day mortality (24.4% vs. 1.4%, p&lt;0.001). In multivariate analysis advanced age, ejection fraction &lt;30% and GFR &lt;30 mL/min/1.73m2 were independent predictors of higher 30-day mortality (OR=10.4; 95% CI: 3.98-25.46).</p><p>CONCLUSIONS: Patients with impaired renal function are older and more often have severe coronary artery disease. Early complications and 30-day mortality were much higher in these patients compared to controls and advanced renal failure and the strongest predictor of 30-day mortality.</p>}},
  author       = {{Sveinsdottir, Nanna and Heidarsdottir, Sunna Run and Steinthorsson, Arni Steinn and Johannesdottir, Hera and Heimisdottir, Alexandra Aldis and Kristjansson, Tomas Thor and Einarsson Long, Thorir and Gudmundsdottir, Ingibjorg and Sigurdsson, Martin Ingi and Gudbjartsson, Tomas}},
  issn         = {{0023-7213}},
  keywords     = {{Coronary Artery Bypass/adverse effects; Coronary Artery Disease/complications; Female; Humans; Male; Renal Insufficiency/complications; Renal Insufficiency, Chronic/complications; Retrospective Studies; Stroke Volume; Ventricular Function, Left}},
  language     = {{ice}},
  number       = {{5}},
  pages        = {{231--237}},
  publisher    = {{Icelandic Medical Association}},
  series       = {{Laeknabladid}},
  title        = {{Áhrif skertrar nýrnastarfsemi á snemmkominn árangur kransæðahjáveituaðgerða}},
  url          = {{http://dx.doi.org/10.17992/lbl.2022.05.690}},
  doi          = {{10.17992/lbl.2022.05.690}},
  volume       = {{108}},
  year         = {{2022}},
}