Virtual Conference
Heart 2022 Conference

Daisuke Endo

Juntendo University, Japan

Title: The impact of chronic kidney disease on long-term prognosis after coronary artery bypass grafting

Abstract

Chronic kidney disease (CKD) was risk factor for cardiovascular event. However, there were few reports about the impact of CKD on long-term outcomes after coronary artery bypass grafting (CABG). Therefore, the present study aims to investigate the impact of CKD on long-term outcomes in patients undergoing CABG. 2,187 patients were included, excluding those with a history of AF, pacemaker implantation, in-hospital death, prolonged hospitalization for more than 30 days, and no remote rhythm data. Primary endpoints were all-cause death, major adverse cardiovascular events (MACE), and late-onset atrial fibrillation (AF). Late-onset AF was defined as occurring after postoperative day 30. Preoperative eGFR greater than or equal to 90 was classified as no CKD group, 45 to 90 as mild-moderate CKD group, and less than 45 as moderate-severe CKD group for comparison. There are 104 in the no CKD group, 1675 in the mild-moderate CKD group, and 408 in moderate-severe CKD group. The mean age of no CKD group was 48 years, significantly younger than that of the other mild-moderate CKD group (68 years) and moderate-severe CKD group (68 years). As CKD grade worsens, hypertension, diabetes mellitus, peripheral arterial disease, history of cerebral infarction, and history of old myocardinal infarction increase. The moderate-severe CKD group includes 179 dialysis cases (43.9%). All cause-survival rate at 15-year was 93.3% in no CKD group, 64.3% in mild-moderate CKD group, and 28.6% in moderate-severe CKD group. Freedom from late-onset AF was 95.8%, 86.9%, and 68.4%, respectively. Freedom from MACE was 86.3%, 68.5%, and 46.7%, respectively. Moderate-severe CKD was independent risk factor of all-cause death and MACE (odds ratio 4.35, 95% CI 1.73-10.94, p value= 0.0018, and odds ratio 3.45, 95% CI 1.74-6.85, p value= 0.0004 ), however not of late-onset AF (odds ratio 2.69, 95% CI 0.60-12.1, p value= 0.20). Long-term prognosis after CABG worsens with worsening CKD grade. Moderate-severe CKD, in particular, was an independent risk factor for all-cause death and MACE.

Biography

Daisuke Endo has completed his PhD at the age of 33 years from Juntendo University, Japan. He is the assistant professor of cardiovascular surgery department of Juntendo University, Japan