Document Detail


Preoperative renal dysfunction and mortality after off-pump coronary artery bypass grafting in Japanese.
MedLine Citation:
PMID:  20668350     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to compare hospital outcomes and long-term survival in Japanese patients with or without renal dysfunction and to estimate the risk of renal dysfunction for survival after isolated off-pump coronary bypass grafting (CABG).
METHODS AND RESULTS: Among 661 consecutive Japanese patients undergoing isolated CABG (656 by the off-pump technique), after exclusion of 51 patients managed with chronic dialysis and 5 patients being revascularized using cardiopulmonary bypass, data from 605 patients were included in the present study. The 30-day mortality was 2.7%, 2.5%, and 0.7% in patients with a glomerular filtration rate (GFR) <30, 30-60, and >60 ml . min(-1) . 1.73 m(-2) (P=0.173). Mean follow-up period was 3.4+/-1.8 years. The 5-year survival free from overall death was 77%, 82%, and 93% in patients with a GFR <30, 30-60, and >60 ml . min(-1) . 1.73 m(-2) (P=0.002). Similarly, the 5-year survival free from cardiovascular death was 82%, 86%, and 97%, respectively (P=0.001). Multivariate Cox model identified GFR as a risk factor of overall death (hazard ratio, 0.82 per 10-ml . min(-1) . 1.73 m(-2) increase, 95% confidence interval, 0.70-0.95, P=0.008) and cardiovascular death (hazard ratio, 0.70 per 10-ml . min(-1) . 1.73 m(-2) increase, 95% confidence interval, 0.57-0.85, P=0.001).
CONCLUSIONS: Off-pump CABG has a relatively low 30-day mortality in patients with renal dysfunction, but preoperative renal dysfunction is an independent risk factor of long-term survival after isolated off-pump CABG in Japanese patients.
Authors:
Takeshi Kinoshita; Tohru Asai; Yoshitaka Murakami; Tomoaki Suzuki; Atsushi Kambara; Keiji Matsubayashi
Publication Detail:
Type:  Journal Article     Date:  2010-07-27
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  74     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-12-22     Revised Date:  2011-02-18    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1866-72     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery, Shiga University of Medical Science, Otsu, Japan. kinotake@belle.shiga-med.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Asian Continental Ancestry Group
Coronary Artery Bypass, Off-Pump / mortality*
Data Collection
Female
Follow-Up Studies
Glomerular Filtration Rate
Humans
Kidney Diseases / mortality*
Male
Middle Aged
Risk Factors
Survival Rate

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