Preoperative Renal Dysfunction and Mortality After Off-Pump Coronary Artery Bypass Grafting in Japanese
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概要
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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. (Circ J 2010; 74: 1866 - 1872)
- 2010-08-25
著者
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MURAKAMI Yoshitaka
Department of Health Science, Shgia University of Medical Science
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Asai Tohru
Division of Cardiology, Kanazawa Cardiovascular Hospital
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MATSUBAYASHI Keiji
Division of Second Surgery, Shiga Medical College
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Murakami Yoshitaka
Department Of Health Science Shiga University Of Medical Science
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KINOSHITA Takeshi
Division of Immunology and Molecular Biology, Cancer Research Institute, Kanazawa University
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Asai Tohru
Department Of Cardiovascular Surgery Shiga University Of Medical Science
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Asai Tohru
Division Of Cardiology Kanazawa Cardiovascular Hospital
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Murakami Yoshitaka
Department Of Health Statistics Shiga University Of Medical Science
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SUZUKI Tomoaki
Division of Cardiovascular Surgery, Shiga University of Medical Science
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KAMBARA Atsushi
Division of Cardiovascular Surgery, Shiga University of Medical Science
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Asai Tohru
Division Of Cardiovascular Surgery Shiga University Of Medical Science
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Kambara Atsushi
Division Of Cardiovascular Surgery Shiga University Of Medical Science
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Matsubayashi Keiji
Division Of Cardiovascular Surgery Shiga University Of Medical Science
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Suzuki Tomoaki
Division Of Cardiovascular Surgery Shiga University Of Medical Science
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Kinoshita Takeshi
Division Of Cardiovascular Surgery Shiga University Of Medical Science
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Murakami Yoshitaka
Department Of Health Science Shgia University Of Medical Science
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Matsubayashi Keiji
Division Of Cardiovascular And Thoracic Surgery Shiga University Of Medical Science
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Asai Tohru
Division Of Cardiovascular And Thoracic Surgery Shiga University Of Medical Science
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Kambara Atsushi
Division Of Cardiovascular And Thoracic Surgery Shiga University Of Medical Science
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Suzuki Tomoaki
Division Of Cardiovascular And Thoracic Surgery Shiga University Of Medical Science
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