PROGNOSTIC VALUE OF RENAL DYSFUNCTION IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER MYOCARDIAL REVASCULARIZATION
The Aim. Study about disturbance of renal dysfunction (RD) and its prognostic significance in patients with ischemic heart disease (IHD) who have undergone myocardial revascularization.
Materials and methods. 675 patients from cardiology department were analyzed by retrospective analysis of history of the disease, in which there was a transfer of percutaneous coronary intervention (PCI) and / or coronary artery bypass surgery. The prevalence of risk factors, features of coronary blood flow, structural and functional changes of the heart were studied.
Statistical processing was performed by SPSS 20.0: descriptive statistics, Mann-Whitney U-test for independent samples, Chi-square, single-factor and multifactorial logistic regression. Differences between the compared variables were considered significant at p<0.05.
Results. PD was detectedin 163 (24,1%) patients, their age was significantly older (p<0,001). The main factors of cardiovascular risk were: arterial hypertension (AH), diabetes mellitus (DM), myocardial infarction (MI) and acute violation of cerebral circulation (AVCC). In 14,2% of cases death was detected from all causes, in the group with PD, significantly more than without (21,5% vs. 11,9%, p=0,002). As a result of a multifactor regression analysis, factors affecting the adverse course of the disease were established: age (p<0,001), creatinine level (p=0,026), EF LV (p<0,001).
Conclusion. Renal dysfunction is one of the main independent predictors of adverse outcome in ischemic heart diseasein patients after myocardial revascularization.
Aisulu S. Zhunuspekova 1, https://orcid.org/0000-0002-2413-317X
Dzhamilya A. Mansurova 1, https://orcid.org/0000-0003-2439-2056
Ainur K. Abylkhairova 2, https://orcid.org/0000-0003-4332-5115
Lyudmila K. Karazhanova 1, http://orcid.org/0000-0002-4719-6034
1 Department of Cardiology and Interventional Arrhythmology,
2 Department of Hospital Therapy
Semey Medical University,
Semey, Kazakhstan.
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9. Charytan D.M., Stern N.M., Mauri L. CKD and coronary collateral supply in individuals undergoing coronary angiography after myocardial infarction. Clinical Journal of the American Society of Nephrology. 2012. № 7. pp. 1079-1086.
10. Charytan D.M., Kuntz R.E., Chhabra A., Cutlip D.E. Relationship of chronic kidney disease to cardiovascular death and myocardial infarction following coronary stenting. Journal of nephrology. 2006. Vol.19, №6. R. 764-770.
11. Chertow G.M., Fan D. et al. Chronic kidney disease and the risks of death, cardiovascular events and hospitalization. N. Engl. J. Med. 2004. Vol.351, №13. R. 1296-1305.
12. Ennezat P.V., Marechaux S. Six-Carpentier M., Pincon C.,Sediri I.,Delsart P., Gras M., Mounier-Véhier C., Gautier C., Montaigne D., et al. Renal resistance index andits prognostic significance in patients with heart failure with preserved ejection fraction. Nephrology Dialysis Transplantation. 2011. №12. P. 3908-3913
13. Gibson C.M., Pinto D.C., Murphy S.A et al. Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality. J Am CollCardiol 2003;42:1535-43.
14. Green S.M., Selzer F., Mulukutla S.R. et al. Comparison of bare-metal and Drug-Eluting Stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry). The American Journal of Cardiology. 2011. № 12. pp. 1658-1664.
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16. Khalique O., Aronow W.S., Ahn C., et al. Relation of moderate or severe reduction in glomerular filtration rate to number of coronary arteries narrowed >50% in patients undergoing coronary angiography for suspected coronary artery disease. American Journal of Cardiology. 2007. №10. pp. 415-426.
17. Kober L., Kjoller E., Torp-Pedersen C. The prognostic importance of creatinineclearanceafter acute myocardial infarction. Eur. Heart J. 2002. Vol. 23, №12. P. 948-952.
18. Ponikowski P., Voors A.D., Anker S., Bueno H.J. Coats A.S., Falk V., Gonzalez-Juanatey J., Harjola V., A. Jankowska E., Jessup M., et.al.2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. 2016. Russian Journal of Cardiology. 2017. №1. pp. 7-81.
19. Roffi M., Patrono C., Collet J.P., Mueller C., Valgimigli M., Andreotti F. et al. 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2016. Vol. 37, № 3. P. 267–315.
20. Sedlis S.P., Jurkovitz C.T., Hartigan P.M., et al. Optimal medical therapy with or without percutaneous coronary intervention for patients with stable coronary artery disease and chronic kidney disease. American Journal of Cardiology. 2009. № 104. pp. 1647-1653.
21. United States Renal Data System. Renal data system chapter 4: Cardiovascular disease in patients with CKD. American Journal of Kidney Diseases. 2016. №3. pp. 49-56.
22. Wetmore J.B., Broce M., Malas A., Almehmi A. Painless myocardial ischemia is associated with mortality in patients with chronic kidney disease. Nephron Clinical Practice. 2012. № 1. pp. 9-16.
23. Windecker S., Kolh P., Alfonso F., Collet J.P., Cremer J., Falk V. et al. 2014 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2014. Vol. 35, №37. P. 2541–2619.
24. Wong J.A., Goodman S.G., Yan R.T. Temporal management patterns and outcomes of non‐ST elevation acute coronary syndromes in patients with kidney dysfunction. European Heart Journal. 2009. №30. pp.549‐557.
25. Wright R.S., Reeder G.S., Herzog C.A. Acute myocardial infarction and renal dysfunction: a high‐risk combination. Ann Intern Med. 2002. Oct. 1. № 137 (7). R. 563-570.
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Жунуспекова А.С., Мансурова Д.А., Абылхаирова А.К., Қаражанова Л.К. Прогностическое значение почечной дисфункции у больных ишемической болезнью сердца после реваскуляризации миокарда // Наука и Здравоохранение. 2019. 1 (Т.21).С. 42-49. Zhunuspekova A.S., Mansurova D.A., Abylkhairova A.K., Karazhanova L.K.. Prognostic value of renal dysfunction in patients with ischemic heart disease after myocardial revascularization. Nauka i Zdravookhranenie [Science & Healthcare]. 2019, (Vol.21) 1, pp. 42-49. Жунуспекова А.С., Мансурова Д.А., Абылхаирова А.К., Қаражанова Л.К. Жүректің ишемиялық ауруы бар миокард реваскуляризациясынан кейінгі науқастарда бүйрек дисфункциясының болжамдық мәні // Ғылым және Денсаулық сақтау. 2019. 1 (Т.21). Б. 42-49.Related publications:
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