Impact of renal function on morbidity and mortality after percutaneous aortocoronary saphenous vein graft intervention
Background Percutaneous coronary intervention in patients with chronic renal insufficiency (CRI) and native coronary artery disease is often problematic, marred by increased morbidity and mortality rates and a high incidence of restenosis and revascularization. However, little is known about the eff...
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| Veröffentlicht in: | The American heart journal 2003-03, Vol.145 (3), p.529-534 |
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| creator | Gruberg, Luis Weissman, Neil J. Pichard, Augusto D. Waksman, Ron Kent, Kenneth M. Satler, Lowell F. Suddath, William O. Pinnow, Ellen E. Gevorkian, Natalie Lindsay, Joseph |
| description | Background Percutaneous coronary intervention in patients with chronic renal insufficiency (CRI) and native coronary artery disease is often problematic, marred by increased morbidity and mortality rates and a high incidence of restenosis and revascularization. However, little is known about the effect of CRI in patients who have undergone prior coronary artery bypass graft surgery and then undergo saphenous vein graft (SVG) intervention.
Methods We analyzed the inhospital and 1-year outcomes of 1265 consecutive patients with normal renal function and varying degrees of renal insufficiency who underwent percutaneous SVG intervention and divided them into 4 groups on the basis of the calculated creatinine clearance (CrCl): group 1, CrCl ≥70 mL per minute (n = 626); group 2, CrCl 50 to 69 mL per minute (n = 357); group 3, CrCl 30 to 49 mL per minute (n = 228); and group 4, CrCl |
| doi_str_mv | 10.1067/mhj.2003.121 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_73128885</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002870302948209</els_id><sourcerecordid>73128885</sourcerecordid><originalsourceid>FETCH-LOGICAL-c458t-5f1447dc1d315ca43e6d39c6f72fc7df2f7058d57d1ce7e1f0ebc4698bb940b13</originalsourceid><addsrcrecordid>eNptkcFrHCEUxqU0NNu0t56LUNJTZqujozPHEtI2EOilPYujz8ZlRqfqLOS_r9NdCJSCIJ_-vsd770PoHSV7SoT8ND8e9i0hbE9b-gLtKBlkIyTnL9GOENI2vSTsEr3O-VClaHvxCl3SVojq7XfoeD8v2hQcHU4Q9ITdGkzxMeB65phGb315wjrYTRU9_VWuQMILJLMWHSCuGev6GU1MMej0hLNeHiFs70fwAf9K1YF9qK4jhK36G3Th9JTh7fm-Qj-_3P24_dY8fP96f_v5oTG860vTOcq5tIZaRjujOQNh2WCEk60z0rrWSdL1tpOWGpBAHYHRcDH04zhwMlJ2hT6e6i4p_l4hFzX7bGCaTm0ryWjb931XwQ__gIe4prqQrGhHeMc4Ixt1c6JMijkncGpJfq4TK0rUloaqaagtDVXTqPj7c9F1nME-w-f1V-D6DOhs9OSSDsbnZ66OMjAhKydOHNRdHT0klY2HYMD6BKYoG_3_O_gDo9ynng</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1504534305</pqid></control><display><type>article</type><title>Impact of renal function on morbidity and mortality after percutaneous aortocoronary saphenous vein graft intervention</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Gruberg, Luis ; Weissman, Neil J. ; Pichard, Augusto D. ; Waksman, Ron ; Kent, Kenneth M. ; Satler, Lowell F. ; Suddath, William O. ; Pinnow, Ellen E. ; Gevorkian, Natalie ; Lindsay, Joseph</creator><creatorcontrib>Gruberg, Luis ; Weissman, Neil J. ; Pichard, Augusto D. ; Waksman, Ron ; Kent, Kenneth M. ; Satler, Lowell F. ; Suddath, William O. ; Pinnow, Ellen E. ; Gevorkian, Natalie ; Lindsay, Joseph</creatorcontrib><description>Background Percutaneous coronary intervention in patients with chronic renal insufficiency (CRI) and native coronary artery disease is often problematic, marred by increased morbidity and mortality rates and a high incidence of restenosis and revascularization. However, little is known about the effect of CRI in patients who have undergone prior coronary artery bypass graft surgery and then undergo saphenous vein graft (SVG) intervention.
Methods We analyzed the inhospital and 1-year outcomes of 1265 consecutive patients with normal renal function and varying degrees of renal insufficiency who underwent percutaneous SVG intervention and divided them into 4 groups on the basis of the calculated creatinine clearance (CrCl): group 1, CrCl ≥70 mL per minute (n = 626); group 2, CrCl 50 to 69 mL per minute (n = 357); group 3, CrCl 30 to 49 mL per minute (n = 228); and group 4, CrCl <30 mL per minute (n = 54). Patients undergoing dialysis replacement therapy were excluded from the study.
Results Patients with lower CrCl more often were older, female, had diabetes mellitus, and had worse left ventricular function. Angiographic baseline characteristics were comparable among the 4 groups. Overall immediate procedural success was similar for all groups. Patients with a low CrCl had significantly higher inhospital overall and cardiac mortality rates (
P < .001), including a significantly higher incidence of myocardial infarction, vascular complications, pulmonary edema, and renal function deterioration. At 1-year follow-up, the overall mortality rates remained significantly higher in patients with decreased CrCl, with an incremental rise in overall mortality rate associated with lower renal function (
P < .001).
Conclusions This study suggests that renal function is a primary determinate of short- and long-term survival in patients undergoing percutaneous SVG intervention and that there is a clear relationship between CrCl and cardiovascular outcome. (Am Heart J 2003;145:529-34.)</description><identifier>ISSN: 0002-8703</identifier><identifier>EISSN: 1097-6744</identifier><identifier>DOI: 10.1067/mhj.2003.121</identifier><identifier>PMID: 12660678</identifier><identifier>CODEN: AHJOA2</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Age Factors ; Aged ; Biological and medical sciences ; Comorbidity ; Coronary Artery Bypass - methods ; Coronary Disease - epidemiology ; Coronary Disease - mortality ; Coronary Disease - surgery ; Creatine - blood ; Creatine - urine ; Diabetes Mellitus - epidemiology ; Female ; Follow-Up Studies ; Glomerular Filtration Rate - physiology ; Hospital Mortality ; Humans ; Hypertension - epidemiology ; Kidney Function Tests ; Male ; Medical sciences ; Middle Aged ; Renal Insufficiency - diagnosis ; Renal Insufficiency - epidemiology ; Renal Insufficiency - metabolism ; Saphenous Vein - transplantation ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart ; Survival Analysis ; Treatment Outcome</subject><ispartof>The American heart journal, 2003-03, Vol.145 (3), p.529-534</ispartof><rights>2003 Mosby, Inc.</rights><rights>2003 INIST-CNRS</rights><rights>Copyright Elsevier Limited Mar 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c458t-5f1447dc1d315ca43e6d39c6f72fc7df2f7058d57d1ce7e1f0ebc4698bb940b13</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002870302948209$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14699367$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12660678$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gruberg, Luis</creatorcontrib><creatorcontrib>Weissman, Neil J.</creatorcontrib><creatorcontrib>Pichard, Augusto D.</creatorcontrib><creatorcontrib>Waksman, Ron</creatorcontrib><creatorcontrib>Kent, Kenneth M.</creatorcontrib><creatorcontrib>Satler, Lowell F.</creatorcontrib><creatorcontrib>Suddath, William O.</creatorcontrib><creatorcontrib>Pinnow, Ellen E.</creatorcontrib><creatorcontrib>Gevorkian, Natalie</creatorcontrib><creatorcontrib>Lindsay, Joseph</creatorcontrib><title>Impact of renal function on morbidity and mortality after percutaneous aortocoronary saphenous vein graft intervention</title><title>The American heart journal</title><addtitle>Am Heart J</addtitle><description>Background Percutaneous coronary intervention in patients with chronic renal insufficiency (CRI) and native coronary artery disease is often problematic, marred by increased morbidity and mortality rates and a high incidence of restenosis and revascularization. However, little is known about the effect of CRI in patients who have undergone prior coronary artery bypass graft surgery and then undergo saphenous vein graft (SVG) intervention.
Methods We analyzed the inhospital and 1-year outcomes of 1265 consecutive patients with normal renal function and varying degrees of renal insufficiency who underwent percutaneous SVG intervention and divided them into 4 groups on the basis of the calculated creatinine clearance (CrCl): group 1, CrCl ≥70 mL per minute (n = 626); group 2, CrCl 50 to 69 mL per minute (n = 357); group 3, CrCl 30 to 49 mL per minute (n = 228); and group 4, CrCl <30 mL per minute (n = 54). Patients undergoing dialysis replacement therapy were excluded from the study.
Results Patients with lower CrCl more often were older, female, had diabetes mellitus, and had worse left ventricular function. Angiographic baseline characteristics were comparable among the 4 groups. Overall immediate procedural success was similar for all groups. Patients with a low CrCl had significantly higher inhospital overall and cardiac mortality rates (
P < .001), including a significantly higher incidence of myocardial infarction, vascular complications, pulmonary edema, and renal function deterioration. At 1-year follow-up, the overall mortality rates remained significantly higher in patients with decreased CrCl, with an incremental rise in overall mortality rate associated with lower renal function (
P < .001).
Conclusions This study suggests that renal function is a primary determinate of short- and long-term survival in patients undergoing percutaneous SVG intervention and that there is a clear relationship between CrCl and cardiovascular outcome. (Am Heart J 2003;145:529-34.)</description><subject>Age Factors</subject><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Comorbidity</subject><subject>Coronary Artery Bypass - methods</subject><subject>Coronary Disease - epidemiology</subject><subject>Coronary Disease - mortality</subject><subject>Coronary Disease - surgery</subject><subject>Creatine - blood</subject><subject>Creatine - urine</subject><subject>Diabetes Mellitus - epidemiology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Hypertension - epidemiology</subject><subject>Kidney Function Tests</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Renal Insufficiency - diagnosis</subject><subject>Renal Insufficiency - epidemiology</subject><subject>Renal Insufficiency - metabolism</subject><subject>Saphenous Vein - transplantation</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><subject>Survival Analysis</subject><subject>Treatment Outcome</subject><issn>0002-8703</issn><issn>1097-6744</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNptkcFrHCEUxqU0NNu0t56LUNJTZqujozPHEtI2EOilPYujz8ZlRqfqLOS_r9NdCJSCIJ_-vsd770PoHSV7SoT8ND8e9i0hbE9b-gLtKBlkIyTnL9GOENI2vSTsEr3O-VClaHvxCl3SVojq7XfoeD8v2hQcHU4Q9ITdGkzxMeB65phGb315wjrYTRU9_VWuQMILJLMWHSCuGev6GU1MMej0hLNeHiFs70fwAf9K1YF9qK4jhK36G3Th9JTh7fm-Qj-_3P24_dY8fP96f_v5oTG860vTOcq5tIZaRjujOQNh2WCEk60z0rrWSdL1tpOWGpBAHYHRcDH04zhwMlJ2hT6e6i4p_l4hFzX7bGCaTm0ryWjb931XwQ__gIe4prqQrGhHeMc4Ixt1c6JMijkncGpJfq4TK0rUloaqaagtDVXTqPj7c9F1nME-w-f1V-D6DOhs9OSSDsbnZ66OMjAhKydOHNRdHT0klY2HYMD6BKYoG_3_O_gDo9ynng</recordid><startdate>20030301</startdate><enddate>20030301</enddate><creator>Gruberg, Luis</creator><creator>Weissman, Neil J.</creator><creator>Pichard, Augusto D.</creator><creator>Waksman, Ron</creator><creator>Kent, Kenneth M.</creator><creator>Satler, Lowell F.</creator><creator>Suddath, William O.</creator><creator>Pinnow, Ellen E.</creator><creator>Gevorkian, Natalie</creator><creator>Lindsay, Joseph</creator><general>Mosby, Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7TS</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20030301</creationdate><title>Impact of renal function on morbidity and mortality after percutaneous aortocoronary saphenous vein graft intervention</title><author>Gruberg, Luis ; Weissman, Neil J. ; Pichard, Augusto D. ; Waksman, Ron ; Kent, Kenneth M. ; Satler, Lowell F. ; Suddath, William O. ; Pinnow, Ellen E. ; Gevorkian, Natalie ; Lindsay, Joseph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c458t-5f1447dc1d315ca43e6d39c6f72fc7df2f7058d57d1ce7e1f0ebc4698bb940b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Age Factors</topic><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Comorbidity</topic><topic>Coronary Artery Bypass - methods</topic><topic>Coronary Disease - epidemiology</topic><topic>Coronary Disease - mortality</topic><topic>Coronary Disease - surgery</topic><topic>Creatine - blood</topic><topic>Creatine - urine</topic><topic>Diabetes Mellitus - epidemiology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular Filtration Rate - physiology</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Hypertension - epidemiology</topic><topic>Kidney Function Tests</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Renal Insufficiency - diagnosis</topic><topic>Renal Insufficiency - epidemiology</topic><topic>Renal Insufficiency - metabolism</topic><topic>Saphenous Vein - transplantation</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><topic>Survival Analysis</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gruberg, Luis</creatorcontrib><creatorcontrib>Weissman, Neil J.</creatorcontrib><creatorcontrib>Pichard, Augusto D.</creatorcontrib><creatorcontrib>Waksman, Ron</creatorcontrib><creatorcontrib>Kent, Kenneth M.</creatorcontrib><creatorcontrib>Satler, Lowell F.</creatorcontrib><creatorcontrib>Suddath, William O.</creatorcontrib><creatorcontrib>Pinnow, Ellen E.</creatorcontrib><creatorcontrib>Gevorkian, Natalie</creatorcontrib><creatorcontrib>Lindsay, Joseph</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Physical Education Index</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gruberg, Luis</au><au>Weissman, Neil J.</au><au>Pichard, Augusto D.</au><au>Waksman, Ron</au><au>Kent, Kenneth M.</au><au>Satler, Lowell F.</au><au>Suddath, William O.</au><au>Pinnow, Ellen E.</au><au>Gevorkian, Natalie</au><au>Lindsay, Joseph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of renal function on morbidity and mortality after percutaneous aortocoronary saphenous vein graft intervention</atitle><jtitle>The American heart journal</jtitle><addtitle>Am Heart J</addtitle><date>2003-03-01</date><risdate>2003</risdate><volume>145</volume><issue>3</issue><spage>529</spage><epage>534</epage><pages>529-534</pages><issn>0002-8703</issn><eissn>1097-6744</eissn><coden>AHJOA2</coden><abstract>Background Percutaneous coronary intervention in patients with chronic renal insufficiency (CRI) and native coronary artery disease is often problematic, marred by increased morbidity and mortality rates and a high incidence of restenosis and revascularization. However, little is known about the effect of CRI in patients who have undergone prior coronary artery bypass graft surgery and then undergo saphenous vein graft (SVG) intervention.
Methods We analyzed the inhospital and 1-year outcomes of 1265 consecutive patients with normal renal function and varying degrees of renal insufficiency who underwent percutaneous SVG intervention and divided them into 4 groups on the basis of the calculated creatinine clearance (CrCl): group 1, CrCl ≥70 mL per minute (n = 626); group 2, CrCl 50 to 69 mL per minute (n = 357); group 3, CrCl 30 to 49 mL per minute (n = 228); and group 4, CrCl <30 mL per minute (n = 54). Patients undergoing dialysis replacement therapy were excluded from the study.
Results Patients with lower CrCl more often were older, female, had diabetes mellitus, and had worse left ventricular function. Angiographic baseline characteristics were comparable among the 4 groups. Overall immediate procedural success was similar for all groups. Patients with a low CrCl had significantly higher inhospital overall and cardiac mortality rates (
P < .001), including a significantly higher incidence of myocardial infarction, vascular complications, pulmonary edema, and renal function deterioration. At 1-year follow-up, the overall mortality rates remained significantly higher in patients with decreased CrCl, with an incremental rise in overall mortality rate associated with lower renal function (
P < .001).
Conclusions This study suggests that renal function is a primary determinate of short- and long-term survival in patients undergoing percutaneous SVG intervention and that there is a clear relationship between CrCl and cardiovascular outcome. (Am Heart J 2003;145:529-34.)</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>12660678</pmid><doi>10.1067/mhj.2003.121</doi><tpages>6</tpages></addata></record> |
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| subjects | Age Factors Aged Biological and medical sciences Comorbidity Coronary Artery Bypass - methods Coronary Disease - epidemiology Coronary Disease - mortality Coronary Disease - surgery Creatine - blood Creatine - urine Diabetes Mellitus - epidemiology Female Follow-Up Studies Glomerular Filtration Rate - physiology Hospital Mortality Humans Hypertension - epidemiology Kidney Function Tests Male Medical sciences Middle Aged Renal Insufficiency - diagnosis Renal Insufficiency - epidemiology Renal Insufficiency - metabolism Saphenous Vein - transplantation Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart Survival Analysis Treatment Outcome |
| title | Impact of renal function on morbidity and mortality after percutaneous aortocoronary saphenous vein graft intervention |
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