Association of Low Glomerular Filtration Rate With the Incidence of Stroke in Patients Following Complete Coronary Revascularization

作者：Konishi Hirokazu; Kasai Takatoshi; Miyauchi Katsumi^*; Kajimoto Kan; Kubota Naozumi; Dohi Tomotaka; Amano Atsushi; Daida Hiroyuki

来源：Circulation Journal, 2011, 75(10): 2372-2378.

DOI：10.1253/circj.CJ-10-1102

• Coronary artery bypass surgery
• Glomerular filtration rate
• Mortality
• Percutaneous coronary intervention

Background: Low glomerular filtration rate (GFR) is associated with a worse outcome after coronary revascularization. Recently, a new specific equation to calculate the estimated GFR (eGFR) in Japanese populations has been reported, and it might be more accurate than the previously used equations. However, the relationship between a low GFR defined using the new equation for the Japanese population and the incidence of stroke following complete coronary revascularization is not yet known.
Methods and Results: Consecutive patients who underwent complete coronary revascularization (percutaneous coronary intervention and bypass surgery) between 1984 and 1992 were enrolled. Patients on dialysis were excluded. Enrolled patients were divided into 2 groups: the preserved GFR group and the low GFR group. Low GFR was defined as eGFR <60 ml.min(-1).1.73m(-2). The incidence of fatal and non-fatal stroke was compared between the groups. Among the 1,809 patients that were enrolled, 321 were placed in the low GFR group. During follow up (mean, 11.4 [2.9] years), there were 127 (7.0%) stroke events. Multivariable analysis using a Cox proportional hazards regression model revealed that the incidence of stroke was significantly higher in the low GFR group than in the preserved GFR group (hazard ratio, 1.66; 95% confidence interval, 1.10-2.48; P=0.008).
Conclusions: Low GFR, defined as eGFR <60 ml.min(-1).1.73m(-2), using a new specific equation for the Japanese population was associated with an increased risk of fatal and non-fatal stroke over a 10-year period after complete coronary revascularization. (Circ J 2011; 75: 2372-2378)

• 出版日期2011-10