Ventricular function and all-cause mortality in chronic kidney disease patients with angiographic coronary artery disease

I. Wen Wu, Ming Jui Hung, Yung Chang Chen, Heng Jung Hsu, Wen Jin Cherng, Chee Jen Chang, Mai Szu Wu

Research output: Contribution to journalArticle

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Abstract

Background: Coronary artery disease (CAD) and chronic kidney disease (CKD) lead to high morbidity and mortality rates. Traditional and nontraditional risk factors, hypertension, fluid overloading and anemia can lead to myocardial ischemia, chamber hypertrophy and dilatation, and low left ventricular ejection fraction (LVEF) in CKD patients. The angiographic feature, ventriculographic LVEF and its relationship to all-cause mortality are unclear in patients with different stages of CKD who are not yet on dialysis. Methods: This retrospective study involved 980 CKD patients with suspected myocardial ischemia who underwent coronary angiography from 1995 to 2004. Demographic, clinical data and ventriculographic LVEF were assessed. Risk estimations for mortality were performed using Cox proportional hazard regression models. Results: Of the CKD patients, 445 (45.4%) had angiographic CAD. Their hemoglobin, body mass index (BMI) and LVEF values decreased with decrease in eGFR. Using Cox proportional hazard regression analysis, low LVEF was independently associated with CKD after adjustment for age, sex, diabetes, hypertension, BMI, hemoglobin and the presence of CAD. Significant independent prognostic factors for mortality included diabetes (hazard ratio [HR]= 2.946; 95% confidence interval [95% CI], 1.185-7.322), BMI (HR=0.864; 95% CI, 0.757-0.985), hemoglobin (HR=0.742; 95% CI, 0.594-0.928) and LVEF (HR=0.944; 95% CI, 0.918-0.970). Low LVEF was the only independent significant prognostic factor in CKD patients with angiographic CAD (HR=0.957; 95% CI, 0.918-0.996). Conclusion: LVEF reduction was independently associated with CKD. Low LVEF was an independent predictor of mortality in CKD patients regardless of the presence of angiographic CAD.

Original languageEnglish
Pages (from-to)181-188
Number of pages8
JournalJournal of Nephrology
Volume23
Issue number2
Publication statusPublished - Mar 2010
Externally publishedYes

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Ventricular Function
Chronic Renal Insufficiency
Stroke Volume
Coronary Artery Disease
Mortality
Confidence Intervals
Hemoglobins
Body Mass Index
Myocardial Ischemia
Hypertension
Coronary Angiography
Proportional Hazards Models
Hypertrophy
Anemia
Dilatation
Dialysis
Retrospective Studies
Regression Analysis
Demography
Morbidity

Keywords

  • All-cause mortality
  • Angiographic coronary artery disease
  • Chronic kidney disease
  • Ejection fraction
  • Left ventricle hypertrophy

ASJC Scopus subject areas

  • Nephrology

Cite this

Wu, I. W., Hung, M. J., Chen, Y. C., Hsu, H. J., Cherng, W. J., Chang, C. J., & Wu, M. S. (2010). Ventricular function and all-cause mortality in chronic kidney disease patients with angiographic coronary artery disease. Journal of Nephrology, 23(2), 181-188.

Ventricular function and all-cause mortality in chronic kidney disease patients with angiographic coronary artery disease. / Wu, I. Wen; Hung, Ming Jui; Chen, Yung Chang; Hsu, Heng Jung; Cherng, Wen Jin; Chang, Chee Jen; Wu, Mai Szu.

In: Journal of Nephrology, Vol. 23, No. 2, 03.2010, p. 181-188.

Research output: Contribution to journalArticle

Wu, I. Wen ; Hung, Ming Jui ; Chen, Yung Chang ; Hsu, Heng Jung ; Cherng, Wen Jin ; Chang, Chee Jen ; Wu, Mai Szu. / Ventricular function and all-cause mortality in chronic kidney disease patients with angiographic coronary artery disease. In: Journal of Nephrology. 2010 ; Vol. 23, No. 2. pp. 181-188.
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T1 - Ventricular function and all-cause mortality in chronic kidney disease patients with angiographic coronary artery disease

AU - Wu, I. Wen

AU - Hung, Ming Jui

AU - Chen, Yung Chang

AU - Hsu, Heng Jung

AU - Cherng, Wen Jin

AU - Chang, Chee Jen

AU - Wu, Mai Szu

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N2 - Background: Coronary artery disease (CAD) and chronic kidney disease (CKD) lead to high morbidity and mortality rates. Traditional and nontraditional risk factors, hypertension, fluid overloading and anemia can lead to myocardial ischemia, chamber hypertrophy and dilatation, and low left ventricular ejection fraction (LVEF) in CKD patients. The angiographic feature, ventriculographic LVEF and its relationship to all-cause mortality are unclear in patients with different stages of CKD who are not yet on dialysis. Methods: This retrospective study involved 980 CKD patients with suspected myocardial ischemia who underwent coronary angiography from 1995 to 2004. Demographic, clinical data and ventriculographic LVEF were assessed. Risk estimations for mortality were performed using Cox proportional hazard regression models. Results: Of the CKD patients, 445 (45.4%) had angiographic CAD. Their hemoglobin, body mass index (BMI) and LVEF values decreased with decrease in eGFR. Using Cox proportional hazard regression analysis, low LVEF was independently associated with CKD after adjustment for age, sex, diabetes, hypertension, BMI, hemoglobin and the presence of CAD. Significant independent prognostic factors for mortality included diabetes (hazard ratio [HR]= 2.946; 95% confidence interval [95% CI], 1.185-7.322), BMI (HR=0.864; 95% CI, 0.757-0.985), hemoglobin (HR=0.742; 95% CI, 0.594-0.928) and LVEF (HR=0.944; 95% CI, 0.918-0.970). Low LVEF was the only independent significant prognostic factor in CKD patients with angiographic CAD (HR=0.957; 95% CI, 0.918-0.996). Conclusion: LVEF reduction was independently associated with CKD. Low LVEF was an independent predictor of mortality in CKD patients regardless of the presence of angiographic CAD.

AB - Background: Coronary artery disease (CAD) and chronic kidney disease (CKD) lead to high morbidity and mortality rates. Traditional and nontraditional risk factors, hypertension, fluid overloading and anemia can lead to myocardial ischemia, chamber hypertrophy and dilatation, and low left ventricular ejection fraction (LVEF) in CKD patients. The angiographic feature, ventriculographic LVEF and its relationship to all-cause mortality are unclear in patients with different stages of CKD who are not yet on dialysis. Methods: This retrospective study involved 980 CKD patients with suspected myocardial ischemia who underwent coronary angiography from 1995 to 2004. Demographic, clinical data and ventriculographic LVEF were assessed. Risk estimations for mortality were performed using Cox proportional hazard regression models. Results: Of the CKD patients, 445 (45.4%) had angiographic CAD. Their hemoglobin, body mass index (BMI) and LVEF values decreased with decrease in eGFR. Using Cox proportional hazard regression analysis, low LVEF was independently associated with CKD after adjustment for age, sex, diabetes, hypertension, BMI, hemoglobin and the presence of CAD. Significant independent prognostic factors for mortality included diabetes (hazard ratio [HR]= 2.946; 95% confidence interval [95% CI], 1.185-7.322), BMI (HR=0.864; 95% CI, 0.757-0.985), hemoglobin (HR=0.742; 95% CI, 0.594-0.928) and LVEF (HR=0.944; 95% CI, 0.918-0.970). Low LVEF was the only independent significant prognostic factor in CKD patients with angiographic CAD (HR=0.957; 95% CI, 0.918-0.996). Conclusion: LVEF reduction was independently associated with CKD. Low LVEF was an independent predictor of mortality in CKD patients regardless of the presence of angiographic CAD.

KW - All-cause mortality

KW - Angiographic coronary artery disease

KW - Chronic kidney disease

KW - Ejection fraction

KW - Left ventricle hypertrophy

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