Impact of Chronic Kidney Disease on Left Main Coronary Artery Disease and Prognosis in Japanese Patients

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概要

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• Background: Renal insufficiency plays a critical role in the pathogenesis of ischemic heart disease. The aim of the present study was to investigate the prevalence of renal dysfunction and its impact on prognosis in patients with left main coronary artery disease (LMCAD) and stable angina pectoris. Methods and Results: A total of 626 consecutive patients with significant coronary artery stenosis were enrolled. Renal insufficiency was graded using estimated glomerular filtration rate (eGFR) before coronary angiography. Chronic kidney disease (CKD) was defined as eGFR <60ml·min–1·1.73m–2 and/or proteinuria. Patients with LMCAD (n=95) had a significantly higher prevalence of CKD than those without LMCAD (P=0.02). Multiple logistic regression analysis showed that CKD was independently associated with LMCAD (adjusted odds ratio, 1.74; 95% confidence interval [CI]: 1.09–2.76, P=0.01). A 1-year follow-up of patients with LMCAD showed that the cumulative incidence of major adverse cardiovascular events among patients with eGFR <30ml·min–1·1.73m–2 was higher than that among patients with eGFR ≥60ml·min–1·1.73m–2 (P=0.03). The hazard ratio for a cardiovascular event was 9.54 (95% CI: 3.15–28.89, P<0.01) when comparing patients with LMCAD and eGFR <30ml·min–1·1.73m–2 vs. patients without LMCAD and eGFR ≥60ml·min–1·1.73m–2. Conclusions: Renal insufficiency is a risk factor for LMCAD and predicts poor prognosis in Japanese patients.  (Circ J 2012; 76: 2266–2272)

• 社団法人　日本循環器学会の論文
• 2012-08-25

著者

• Kusano Kengo

  Dep. Of Cardiovascular Medicine Graduate School Of Medicine Dentistry And Pharmaceutical Sciences Ok

• Kato Kenichi

  横浜労災病院 循環器科

• Katoh Kenichi

  Yokohama Rosai Hospital

• Kusano Kengo

  岡山大学 医歯薬学総合研究科循環器内科

• Nakamura K

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Ueeda Masayuki

  Department Of Cardiology Mitoyo General Hospital

• Ueeda Masayuki

  Division Of Cardiology Mitoyo General Hospital

• Dan Kazuhiro

  Department Of Cardiology Mitoyo General Hospital

• Kusano Kengo

  Department Of Cardiology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical

• Nakamura Kazufumi

  Department Of Cardiology Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical

• Miyoshi Toru

  Department Of Molecular Biology And Biochemistry Okayama University Graduate School Of Medicine Dent

• Takaishi Atsushi

  Department Of Cardiology Mitoyo General Hospital

• Fukushima Kusano

  Department Of Cardiovascular Medicine Okayama University Medical School

• Ugawa Satoko

  Department Of Cardiology Mitoyo General Hospital

• Nakamura Kazufumi

  Division Of Cardiology Gunma Prefectural Cardiovascular Center

• Ohnishi Nobuhiko

  Department Of Cardiology Mitoyo General Hospital

• Onishi Nobuhiko

  Division Of Cardiology Mitoyo General Hospital

• Kumagai Naoko

  Department Of Cardiovascular Medicine Okayama University Graduate School Of Medicine Dentistry And P

• Nakamura Kazufumi

  Department Of Cardiovascular Medicine Okayama University Graduate School Of Medicine Dentistry And P

• Nakahawa Koji

  Department Of Cardiology Okayama University

• Ito Hiroshi

  Department Neurosurgery Tokyo Medical College

• Ito Hiroshi

  Department Of Cardiovascular Medicine Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sciences

• Miyoshi Toru

  Department Of Cardiovascular Medicine Okayama University Graduate School Of Medicine Dentistry And Pharmaceutical Sciences

• OHTSUKA Hiroaki

  Department of Cardiovascular Medicine, Mitoyo General Hospital

• Katoh Kennichi

  Cardiovascular Center Toranomon Hospital

• Ohtsuka Hiroaki

  Department Of Cardiovascular Medicine Mitoyo General Hospital

• NAKAMURA Kazufumi

  Department of Applied Chemistry, Tokai University

• Nakamura Kazufumi

  Department of Applied Chemistry, Faculty of Science and Technology, Keio University

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