| 000 | 02610 am a22003013u 4500 | ||
|---|---|---|---|
| 042 | _adc | ||
| 100 | 1 | 0 |
_aDoenst, Torsten _eauthor _9965 |
| 700 | 1 | 0 |
_aHaddad, Haissam _eauthor _9966 |
| 700 | 1 | 0 |
_aStebbins, Amanda _eauthor _9967 |
| 700 | 1 | 0 |
_aHill, James A. _eauthor _9968 |
| 700 | 1 | 0 |
_aVelazquez, Eric J. _eauthor _9969 |
| 700 | 1 | 0 |
_aLee, Kerry L. _eauthor _9970 |
| 700 | 1 | 0 |
_aRouleau, Jean L. _eauthor _9971 |
| 700 | 1 | 0 |
_aSopko, George _eauthor _9972 |
| 700 | 1 | 0 |
_aFarsky, Pedro S. _eauthor _9973 |
| 700 | 1 | 0 |
_aAl-Khalidi, Hussein R. _eauthor _9974 |
| 245 | 0 | 0 | _aRenal Function and Coronary Bypass Surgery in Patients With Ischemic Heart Failure |
| 260 | _c2022-02. | ||
| 500 | _a/pmc/articles/PMC7541611/ | ||
| 500 | _a/pubmed/32386761 | ||
| 520 | _aOBJECTIVE: Chronic kidney disease (CKD) is a known risk factor in cardiovascular (CV) disease but its influence on treatment effect of bypass surgery (CABG) remains unclear. We assessed the influence of CKD on 10-year mortality and CV-outcomes in ischemic HF patients treated with medical therapy (MED) with or without CABG. METHODS: We calculated baseline estimated glomerular filtration rate (eGFR, CKD-EPI formula, CKD stages 1-5) from 1,209 patients randomized to MED or CABG in the Surgical Treatment for IsChemic Heart failure (STICH) trial and assessed its effect on outcome. RESULTS: In the overall STICH cohort, patients in CKD stages 3-5 were older than those in stages 1/2 (66-71 vs. 54-59 years) and had more comorbidities. Multivariable modeling revealed an inverse association between eGFR and risk of death, CV death and/or CV-rehospitalization (all p<0.001, but not for stroke, p=0.697). Baseline characteristics of the two treatment arms were equal for each CKD stage. There were significant improvements in death or CV-rehospitalization with CABG (Stage 1: HR 0.71, CI 0.53-0.96, p=0.02; Stage 2: HR 0.71, CI 0.59-0.84, p<0.0001; Stage 3: HR 0.76, CI 0.53-0.96, p=0.03). These data were inconclusive in stages 4/5 for insufficient patient numbers (N=28). There was no significant interaction of eGFR with the treatment effect of CABG (p=0.25 for death and 0.54 for death or CV-rehospitalization). CONCLUSIONS: Chronic kidney disease is an independent risk factor for mortality in patients with ischemic HF with or without CABG. However, mild to moderate CKD does not appear to influence long-term treatment effects of CABG. | ||
| 540 | _a | ||
| 546 | _aen | ||
| 690 | _aArticle | ||
| 655 | 7 |
_aText _2local |
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| 786 | 0 | _nJ Thorac Cardiovasc Surg | |
| 856 | 4 | 1 |
_uhttp://dx.doi.org/10.1016/j.jtcvs.2020.02.136 _zConnect to this object online. |
| 999 |
_c1715 _d1715 |
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