Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome
Objective: To determine the impact of CKD on the completeness of revascularization and major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS). Patients and methods: The study enrolled 400 CCS patients who underwent revascularization by PCI. They were separated in...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-01-01
|
| Series: | Indian Heart Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S001948322300192X |
| _version_ | 1797267188393967616 |
|---|---|
| author | Shereen Ibrahim Farag Shaimaa Ahmed Mostafa Hamza Kabil Mohamed Reda Elfaramawy |
| author_facet | Shereen Ibrahim Farag Shaimaa Ahmed Mostafa Hamza Kabil Mohamed Reda Elfaramawy |
| author_sort | Shereen Ibrahim Farag |
| collection | DOAJ |
| description | Objective: To determine the impact of CKD on the completeness of revascularization and major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS). Patients and methods: The study enrolled 400 CCS patients who underwent revascularization by PCI. They were separated into two categories according to their eGFR levels: the control group: 200 patients with eGFR ≥60mL/min/1.73m2, and the CKD Group: 200 patients with eGFR< 60ml/min/1.73m.2 Patients were reclassified according to revascularization into complete and incomplete revascularization groups with one-year follow-up to assess the MACE. Results: CKD patients were significantly older (65.78 ± 6.41 vs. 56.70 ± 9.20 years, P=<0.001). They had higher syntax scores (P = 0.005), CIN (P = 0.001), all-cause mortality (P = 0.02), MACE (P = 0.037), and heart failure (P = 0.014). After reclassification according to revascularization. GFR was significantly reduced among patients with incomplete revascularization (51.08 ± 28.15 vs. 65.67 ± 26.62, respectively, P =<0.001). Repeated revascularization (P < 0.001), STEMI (P = 0.003), stent thrombosis (P = 0.015), MACE (P < 0.001), stroke (P < 0.001), and all-cause mortality (P < 0.001) were more prevalent among patients with incomplete revascularization. Multivariate regression analysis revealed eGFR (P = 0.001) and Syntax score (SS) (P=<0.001) as independent predictors of incomplete revascularization. The optimal eGFR cutoff value for predicting partial revascularization is 49.50mL/min/1.73m2, with 58.8% sensitivity and 69.3 % specificity. Conclusion: Chronic kidney disease is associated with a higher syntax score and incomplete revascularization prevalence in CCS patients. Additionally, incomplete revascularization is associated with an increased incidence of major adverse cardiac events. In patients with CCS, CKD predicts partial revascularization and subsequent MACE. |
| first_indexed | 2024-04-25T01:12:37Z |
| format | Article |
| id | doaj.art-869fa63886d74565bbed9fd71c98f99f |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-04-25T01:12:37Z |
| publishDate | 2024-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-869fa63886d74565bbed9fd71c98f99f2024-03-10T05:11:09ZengElsevierIndian Heart Journal0019-48322024-01-017612226Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndromeShereen Ibrahim Farag0Shaimaa Ahmed Mostafa1Hamza Kabil2Mohamed Reda Elfaramawy3Benha University, Faculty of Medicine, Cardiology Department, Benha, Egypt; Corresponding author. Benha University hospital, Farid Nada Street, Benha, Egypt, 13512, Egypt.Benha University, Faculty of Medicine, Cardiology Department, Benha, EgyptDamiette University, Faculty of Medicine, Cardiology Department, EgyptAl-Ahara Teaching Hospital, Zagazig, El-Sharqia Governorate, EgyptObjective: To determine the impact of CKD on the completeness of revascularization and major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS). Patients and methods: The study enrolled 400 CCS patients who underwent revascularization by PCI. They were separated into two categories according to their eGFR levels: the control group: 200 patients with eGFR ≥60mL/min/1.73m2, and the CKD Group: 200 patients with eGFR< 60ml/min/1.73m.2 Patients were reclassified according to revascularization into complete and incomplete revascularization groups with one-year follow-up to assess the MACE. Results: CKD patients were significantly older (65.78 ± 6.41 vs. 56.70 ± 9.20 years, P=<0.001). They had higher syntax scores (P = 0.005), CIN (P = 0.001), all-cause mortality (P = 0.02), MACE (P = 0.037), and heart failure (P = 0.014). After reclassification according to revascularization. GFR was significantly reduced among patients with incomplete revascularization (51.08 ± 28.15 vs. 65.67 ± 26.62, respectively, P =<0.001). Repeated revascularization (P < 0.001), STEMI (P = 0.003), stent thrombosis (P = 0.015), MACE (P < 0.001), stroke (P < 0.001), and all-cause mortality (P < 0.001) were more prevalent among patients with incomplete revascularization. Multivariate regression analysis revealed eGFR (P = 0.001) and Syntax score (SS) (P=<0.001) as independent predictors of incomplete revascularization. The optimal eGFR cutoff value for predicting partial revascularization is 49.50mL/min/1.73m2, with 58.8% sensitivity and 69.3 % specificity. Conclusion: Chronic kidney disease is associated with a higher syntax score and incomplete revascularization prevalence in CCS patients. Additionally, incomplete revascularization is associated with an increased incidence of major adverse cardiac events. In patients with CCS, CKD predicts partial revascularization and subsequent MACE.http://www.sciencedirect.com/science/article/pii/S001948322300192XChronic coronary syndromeChronic kidney diseaseIncomplete revascularization |
| spellingShingle | Shereen Ibrahim Farag Shaimaa Ahmed Mostafa Hamza Kabil Mohamed Reda Elfaramawy Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome Indian Heart Journal Chronic coronary syndrome Chronic kidney disease Incomplete revascularization |
| title | Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome |
| title_full | Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome |
| title_fullStr | Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome |
| title_full_unstemmed | Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome |
| title_short | Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome |
| title_sort | chronic kidney disease s impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome |
| topic | Chronic coronary syndrome Chronic kidney disease Incomplete revascularization |
| url | http://www.sciencedirect.com/science/article/pii/S001948322300192X |
| work_keys_str_mv | AT shereenibrahimfarag chronickidneydiseasesimpactonrevascularizationandsubsequentmajoradversecardiovasculareventsinpatientswithchroniccoronarysyndrome AT shaimaaahmedmostafa chronickidneydiseasesimpactonrevascularizationandsubsequentmajoradversecardiovasculareventsinpatientswithchroniccoronarysyndrome AT hamzakabil chronickidneydiseasesimpactonrevascularizationandsubsequentmajoradversecardiovasculareventsinpatientswithchroniccoronarysyndrome AT mohamedredaelfaramawy chronickidneydiseasesimpactonrevascularizationandsubsequentmajoradversecardiovasculareventsinpatientswithchroniccoronarysyndrome |