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Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007.
Hypertens Res. 2009 Oct; 32(10):920-6.HR

Abstract

Patients with coronary artery disease (CAD) frequently have impaired renal function, but the prevalence and influence of renal dysfunction on their prognosis in Japan remain uncertain. With a prospective study comprising all the new patients who had visited our hospital between 2004 and 2007 (n=6562), we investigated the prevalence of renal dysfunction and its influence on the prognosis of CAD patients. The glomerular filtration rate (GFR) was calculated by using the GFR equation used for the Japanese population. Of those, 797 patients with CAD and blood tests available were analyzed (median follow-up periods of 693 days). Patients were further classified into four subgroups according to estimated GFR value (eGFR): normal (90< or =eGFR, 12.2%), mildly impaired (60< or =eGFR<90, 58.3%), moderately impaired (30< or =eGFR<60, 23.6%) and severely impaired renal function (eGFR<30, 5.9%). The 2-year survival and cardiovascular event (cardiac death, nonfatal myocardial infarction or readmission for heart failure)-free rates were significantly different among the four subgroups: 98.9, 97.7, 89.3 vs. 67.8%, respectively (P<0.001 for trend), and 100, 98.8, 89.0 vs. 70.0%, respectively (P<0.001 for trend). The age- and gender-adjusted mortality increased significantly in moderately impaired (hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.383-7.017) and in severely impaired subgroups (HR 10.1, 95% CI 4.244-24.178) compared with those with eGFR of 60 or more. After adjustment for baseline differences, eGFR was independently associated with death and cardiovascular events (HR 0.983 and 0.981, 95% CI 0.968-0.998 and 0.965-0.998, respectively). In conclusion, our study identified the prevalence and association of eGFR with prognosis in Japanese patients with CAD, suggesting that strict care for not only CAD but also renal dysfunction is needed for further prevention of cardiovascular events.

Authors+Show Affiliations

The Cardiovascular Institute, Roppongi, Minato-ku, Tokyo, Japan. nmichi-kyu@umin.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19696780

Citation

Nakamura, Michinari, et al. "Impact of Reduced Renal Function On Prognosis in Japanese Patients With Coronary Artery Disease: a Prospective Cohort of Shinken Database 2007." Hypertension Research : Official Journal of the Japanese Society of Hypertension, vol. 32, no. 10, 2009, pp. 920-6.
Nakamura M, Yamashita T, Yajima J, et al. Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007. Hypertens Res. 2009;32(10):920-6.
Nakamura, M., Yamashita, T., Yajima, J., Oikawa, Y., Ogasawara, K., Kirigaya, H., Sagara, K., Koike, A., Sawada, H., & Aizawa, T. (2009). Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007. Hypertension Research : Official Journal of the Japanese Society of Hypertension, 32(10), 920-6. https://doi.org/10.1038/hr.2009.114
Nakamura M, et al. Impact of Reduced Renal Function On Prognosis in Japanese Patients With Coronary Artery Disease: a Prospective Cohort of Shinken Database 2007. Hypertens Res. 2009;32(10):920-6. PubMed PMID: 19696780.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of reduced renal function on prognosis in Japanese patients with coronary artery disease: a prospective cohort of Shinken Database 2007. AU - Nakamura,Michinari, AU - Yamashita,Takeshi, AU - Yajima,Junji, AU - Oikawa,Yuji, AU - Ogasawara,Ken, AU - Kirigaya,Hajime, AU - Sagara,Koichi, AU - Koike,Akira, AU - Sawada,Hitoshi, AU - Aizawa,Tadanori, Y1 - 2009/08/21/ PY - 2009/8/22/entrez PY - 2009/8/22/pubmed PY - 2009/12/31/medline SP - 920 EP - 6 JF - Hypertension research : official journal of the Japanese Society of Hypertension JO - Hypertens Res VL - 32 IS - 10 N2 - Patients with coronary artery disease (CAD) frequently have impaired renal function, but the prevalence and influence of renal dysfunction on their prognosis in Japan remain uncertain. With a prospective study comprising all the new patients who had visited our hospital between 2004 and 2007 (n=6562), we investigated the prevalence of renal dysfunction and its influence on the prognosis of CAD patients. The glomerular filtration rate (GFR) was calculated by using the GFR equation used for the Japanese population. Of those, 797 patients with CAD and blood tests available were analyzed (median follow-up periods of 693 days). Patients were further classified into four subgroups according to estimated GFR value (eGFR): normal (90< or =eGFR, 12.2%), mildly impaired (60< or =eGFR<90, 58.3%), moderately impaired (30< or =eGFR<60, 23.6%) and severely impaired renal function (eGFR<30, 5.9%). The 2-year survival and cardiovascular event (cardiac death, nonfatal myocardial infarction or readmission for heart failure)-free rates were significantly different among the four subgroups: 98.9, 97.7, 89.3 vs. 67.8%, respectively (P<0.001 for trend), and 100, 98.8, 89.0 vs. 70.0%, respectively (P<0.001 for trend). The age- and gender-adjusted mortality increased significantly in moderately impaired (hazard ratio (HR) 3.1, 95% confidence interval (CI) 1.383-7.017) and in severely impaired subgroups (HR 10.1, 95% CI 4.244-24.178) compared with those with eGFR of 60 or more. After adjustment for baseline differences, eGFR was independently associated with death and cardiovascular events (HR 0.983 and 0.981, 95% CI 0.968-0.998 and 0.965-0.998, respectively). In conclusion, our study identified the prevalence and association of eGFR with prognosis in Japanese patients with CAD, suggesting that strict care for not only CAD but also renal dysfunction is needed for further prevention of cardiovascular events. SN - 1348-4214 UR - https://www.unboundmedicine.com/medline/citation/19696780/Impact_of_reduced_renal_function_on_prognosis_in_Japanese_patients_with_coronary_artery_disease:_a_prospective_cohort_of_Shinken_Database_2007_ L2 - https://medlineplus.gov/coronaryarterydisease.html DB - PRIME DP - Unbound Medicine ER -