Chronic kidney disease predicts poor prognosis in patients with stable premature coronary artery disease |
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Authors: | Zhen Ding Xing Wang Zhong Chen Xiaofeng Zhang Chengchun Tang Yi Feng Genshan Ma |
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Affiliation: | 1. Department of Internal Medicine, American University of Beirut Medical Center, PO Box 11-0236, Riad El-Solh 1107-2020, Beirut, Lebanon;2. Department of Medicine, Emory University School of Medicine, 1648 Pierce Drive, N.E., Atlanta, GA 30322, USA;3. Department of Medicine, MedStar Good Samaritan Hospital, 5601 Loch Raven Boulevard, Baltimore, MD 21239, USA;4. Department of Internal Medicine, Texas Tech University Health Sciences Center, Amarillo, 1400S, Coulter Street, Amarillo, TX 79106, USA;1. Department of Internal Medicine, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Catalonia, Spain;2. Emergency Department, Bellvitge University Hospital, Bellvitge Biomedical Research Institute-IDIBELL, Barcelona, Catalonia, Spain;3. Department of Health Service Research, International University of Catalonia, Barcelona, Catalonia, Spain;4. Department of Medicine, University of Barcelona, Barcelona, Catalonia, Spain;5. European Federation of Internal Medicine Executive Committee, Brussels, Belgium;1. Tropical Diseases Unit, Policlinico Umberto I, Rome, Italy;2. Department of Experimental and Clinical Medicine, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy;3. National Institute of Health, Viale Regina Elena 299, Rome, Italy;4. Department of Medical Sciences, University “Magna Graecia” of Catanzaro, Viale Europa, Loc. Germaneto, 88100 Catanzaro, Italy;5. “Sersale''s Study” Collaborating Group: C. Costa, M. R. Scarpino, V. Aiello, G. Pandolfo, L. Scalise (Chair of Infectious Diseases, University “Magna Graecia” of Catanzaro); S. Scalzi (Person responsible for the Sersale Polyambulatories); A. Elia, F. Lia, T. Perri, P. Valente (General Practitioners, Sersale); F. Scalise (Pediatrician, Sersale);1. Editor in Chief of Diabetes Voice and Emeritus Professor of Clinical Epidemiology, Swansea University, UK;2. Managing Editor of Diabetes Voice and IDF Head of Communications, Belgium;1. Department of Epidemiology, University of Alabama at Birmingham, 1530 3rd Avenue South, RPHB 217C, Birmingham, AL 35294, USA;2. Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 701 19th Street South, LHRB 310, Birmingham, AL 35294, USA |
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Abstract: | ObjectiveThis study was performed to determine the prevalence of chronic kidney disease (CKD) as well as its association with mid-term prognosis in patients with stable premature coronary artery disease (CAD) in a Chinese population.MethodsFive hundred and twelve patients from Jiangsu Province, China with stable, premature CAD were enrolled using an estimated glomerular filtration rate (eGFR) to determine the presence of CKD. The patients were then monitored over a two-year follow up during which major adverse cardiac events (MACEs) were recorded and analyzed.ResultsOne hundred and eighty-three patients (35.74%) were determined to have CKD. Having CKD was associated with a higher ratio of type 2 diabetes mellitus, multi-vessel disease, higher levels of fasting blood sugar and lower levels of left ventricular ejection fraction (all P < 0.05). Patients with CKD had significantly higher incidences of composite MACEs than the non-CKD group at the end of the two- (45.35% vs 30.72%, P = 0.001) but not one-year follow up (30.64% vs 25.32%, P = 0.209). Furthermore, as eGFR decreased, more MACEs occurred (all P < 0.05). Multivariate analysis confirmed that both CKD (P < 0.001) and multi-vessel disease (P < 0.001) are independent risk factors for MACEs.ConclusionChinese patients diagnosed with stable, premature CAD and CKD have more risk factors and worse two-year outcomes than those with only CAD. |
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