Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up

Graham Scott Hillis, Bernard Lewis Croal, K. G. Buchan, H. El-Shafei, G. Gibson, R. R. Jeffrey, C. G. M. Millar, Gordon James Prescott, Brian Cuthbertson

Research output: Contribution to journalArticle

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Abstract

Background - Severe renal dysfunction is associated with a worse outcome after coronary artery bypass graft surgery (CABG). Less is known about the effects of milder degrees of renal impairment, and previous studies have relied on levels of serum creatinine, an insensitive indicator of renal function. Recent studies have suggested that estimated glomerular filtration rate (eGFR) is a more discriminatory measure. However, data on the utility of eGFR in predicting outcome from CABG are limited.

Methods and Results - We studied 2067 consecutive patients undergoing CABG. Demographic and clinical data were collected preoperatively, and patients were followed up a median of 2.3 years after surgery. Estimated GFR was calculated from the Modification of Diet in Renal Disease equation. The primary outcome was all-cause mortality. Mean +/- SD eGFR was 57.9 +/- 17.6 mL/min per 1.73 m(2) in the 158 patients who died during follow-up compared with 64.7 +/- 13.8 mL/min per 1.73 m(2) in survivors ( hazard ratio [HR], 0.71 per 10 mL/min per 1.73 m(2); 95% CI, 0.64 to 0.80; P < 0.001). Estimated GFR was an independent predictor of mortality in both models with other individual univariable predictors (HR, 0.80 per 10 mL/min per 1.73 m(2); 95% CI, 0.72 to 0.89; P < 0.001) and the European system for cardiac operative risk evaluation (HR, 0.88 per 10 mL/min per 1.73 m(2); 95% CI, 0.78 to 0.98; P = 0.02).

Conclusions - Estimated GFR is a powerful and independent predictor of mortality after CABG.

Original languageEnglish
Pages (from-to)1056-1062
Number of pages6
JournalCirculation
Volume113
Issue number8
DOIs
Publication statusPublished - Feb 2006

Keywords

  • coronary disease
  • kidney
  • surgery
  • survival
  • CHRONIC KIDNEY-DISEASE
  • CARDIAC-SURGERY
  • DIALYSIS PATIENTS
  • CARDIOVASCULAR OUTCOMES
  • INSUFFICIENCY
  • RISK
  • DYSFUNCTION
  • FAILURE
  • DEATH
  • REVASCULARIZATION

Cite this

Hillis, G. S., Croal, B. L., Buchan, K. G., El-Shafei, H., Gibson, G., Jeffrey, R. R., ... Cuthbertson, B. (2006). Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up. Circulation, 113(8), 1056-1062. https://doi.org/10.1161/CIRCULATIONAHA.105.591990

Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up. / Hillis, Graham Scott; Croal, Bernard Lewis; Buchan, K. G.; El-Shafei, H.; Gibson, G.; Jeffrey, R. R.; Millar, C. G. M.; Prescott, Gordon James; Cuthbertson, Brian.

In: Circulation, Vol. 113, No. 8, 02.2006, p. 1056-1062.

Research output: Contribution to journalArticle

Hillis, GS, Croal, BL, Buchan, KG, El-Shafei, H, Gibson, G, Jeffrey, RR, Millar, CGM, Prescott, GJ & Cuthbertson, B 2006, 'Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up', Circulation, vol. 113, no. 8, pp. 1056-1062. https://doi.org/10.1161/CIRCULATIONAHA.105.591990
Hillis, Graham Scott ; Croal, Bernard Lewis ; Buchan, K. G. ; El-Shafei, H. ; Gibson, G. ; Jeffrey, R. R. ; Millar, C. G. M. ; Prescott, Gordon James ; Cuthbertson, Brian. / Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up. In: Circulation. 2006 ; Vol. 113, No. 8. pp. 1056-1062.
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abstract = "Background - Severe renal dysfunction is associated with a worse outcome after coronary artery bypass graft surgery (CABG). Less is known about the effects of milder degrees of renal impairment, and previous studies have relied on levels of serum creatinine, an insensitive indicator of renal function. Recent studies have suggested that estimated glomerular filtration rate (eGFR) is a more discriminatory measure. However, data on the utility of eGFR in predicting outcome from CABG are limited.Methods and Results - We studied 2067 consecutive patients undergoing CABG. Demographic and clinical data were collected preoperatively, and patients were followed up a median of 2.3 years after surgery. Estimated GFR was calculated from the Modification of Diet in Renal Disease equation. The primary outcome was all-cause mortality. Mean +/- SD eGFR was 57.9 +/- 17.6 mL/min per 1.73 m(2) in the 158 patients who died during follow-up compared with 64.7 +/- 13.8 mL/min per 1.73 m(2) in survivors ( hazard ratio [HR], 0.71 per 10 mL/min per 1.73 m(2); 95{\%} CI, 0.64 to 0.80; P < 0.001). Estimated GFR was an independent predictor of mortality in both models with other individual univariable predictors (HR, 0.80 per 10 mL/min per 1.73 m(2); 95{\%} CI, 0.72 to 0.89; P < 0.001) and the European system for cardiac operative risk evaluation (HR, 0.88 per 10 mL/min per 1.73 m(2); 95{\%} CI, 0.78 to 0.98; P = 0.02).Conclusions - Estimated GFR is a powerful and independent predictor of mortality after CABG.",
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author = "Hillis, {Graham Scott} and Croal, {Bernard Lewis} and Buchan, {K. G.} and H. El-Shafei and G. Gibson and Jeffrey, {R. R.} and Millar, {C. G. M.} and Prescott, {Gordon James} and Brian Cuthbertson",
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T1 - Renal function and outcome from coronary artery bypass grafting: impact on mortality after a 2.3-year follow-up

AU - Hillis, Graham Scott

AU - Croal, Bernard Lewis

AU - Buchan, K. G.

AU - El-Shafei, H.

AU - Gibson, G.

AU - Jeffrey, R. R.

AU - Millar, C. G. M.

AU - Prescott, Gordon James

AU - Cuthbertson, Brian

PY - 2006/2

Y1 - 2006/2

N2 - Background - Severe renal dysfunction is associated with a worse outcome after coronary artery bypass graft surgery (CABG). Less is known about the effects of milder degrees of renal impairment, and previous studies have relied on levels of serum creatinine, an insensitive indicator of renal function. Recent studies have suggested that estimated glomerular filtration rate (eGFR) is a more discriminatory measure. However, data on the utility of eGFR in predicting outcome from CABG are limited.Methods and Results - We studied 2067 consecutive patients undergoing CABG. Demographic and clinical data were collected preoperatively, and patients were followed up a median of 2.3 years after surgery. Estimated GFR was calculated from the Modification of Diet in Renal Disease equation. The primary outcome was all-cause mortality. Mean +/- SD eGFR was 57.9 +/- 17.6 mL/min per 1.73 m(2) in the 158 patients who died during follow-up compared with 64.7 +/- 13.8 mL/min per 1.73 m(2) in survivors ( hazard ratio [HR], 0.71 per 10 mL/min per 1.73 m(2); 95% CI, 0.64 to 0.80; P < 0.001). Estimated GFR was an independent predictor of mortality in both models with other individual univariable predictors (HR, 0.80 per 10 mL/min per 1.73 m(2); 95% CI, 0.72 to 0.89; P < 0.001) and the European system for cardiac operative risk evaluation (HR, 0.88 per 10 mL/min per 1.73 m(2); 95% CI, 0.78 to 0.98; P = 0.02).Conclusions - Estimated GFR is a powerful and independent predictor of mortality after CABG.

AB - Background - Severe renal dysfunction is associated with a worse outcome after coronary artery bypass graft surgery (CABG). Less is known about the effects of milder degrees of renal impairment, and previous studies have relied on levels of serum creatinine, an insensitive indicator of renal function. Recent studies have suggested that estimated glomerular filtration rate (eGFR) is a more discriminatory measure. However, data on the utility of eGFR in predicting outcome from CABG are limited.Methods and Results - We studied 2067 consecutive patients undergoing CABG. Demographic and clinical data were collected preoperatively, and patients were followed up a median of 2.3 years after surgery. Estimated GFR was calculated from the Modification of Diet in Renal Disease equation. The primary outcome was all-cause mortality. Mean +/- SD eGFR was 57.9 +/- 17.6 mL/min per 1.73 m(2) in the 158 patients who died during follow-up compared with 64.7 +/- 13.8 mL/min per 1.73 m(2) in survivors ( hazard ratio [HR], 0.71 per 10 mL/min per 1.73 m(2); 95% CI, 0.64 to 0.80; P < 0.001). Estimated GFR was an independent predictor of mortality in both models with other individual univariable predictors (HR, 0.80 per 10 mL/min per 1.73 m(2); 95% CI, 0.72 to 0.89; P < 0.001) and the European system for cardiac operative risk evaluation (HR, 0.88 per 10 mL/min per 1.73 m(2); 95% CI, 0.78 to 0.98; P = 0.02).Conclusions - Estimated GFR is a powerful and independent predictor of mortality after CABG.

KW - coronary disease

KW - kidney

KW - surgery

KW - survival

KW - CHRONIC KIDNEY-DISEASE

KW - CARDIAC-SURGERY

KW - DIALYSIS PATIENTS

KW - CARDIOVASCULAR OUTCOMES

KW - INSUFFICIENCY

KW - RISK

KW - DYSFUNCTION

KW - FAILURE

KW - DEATH

KW - REVASCULARIZATION

U2 - 10.1161/CIRCULATIONAHA.105.591990

DO - 10.1161/CIRCULATIONAHA.105.591990

M3 - Article

VL - 113

SP - 1056

EP - 1062

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 8

ER -