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Association of moderate chronic kidney disease with insufficient improvement of fractional flow reserve after stent implantation.
- Source :
-
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2016 Aug; Vol. 88 (2), pp. E38-44. Date of Electronic Publication: 2015 Oct 22. - Publication Year :
- 2016
-
Abstract
- Objectives: This study aims to investigate the association of moderate chronic kidney disease (CKD) with fractional flow reserve (FFR) after stent implantation.<br />Background: Patients with moderate CKD have a higher prevalence of severe and diffuse coronary artery disease, and have increased risk of cardiovascular events even after stent implantation. On the other hand, in some patients, FFR could not be sufficiently improved even after stent implantation. However, the association between these pathophysiological processes is unclear.<br />Methods and Results: A total of 102 patients with stable angina, in whom a stent was implanted for the left anterior descending coronary artery (LAD) lesion, were included. Patients with a severely decreased glomerular filtration rate (GFR; > CKD stage 4) were excluded. Patients were stratified into 3 groups: those with an estimated GFR (eGFR) ≥ 60 mL per min per 1.73 m(2) (stage 0-2), 45 to 59 mL per min per 1.73 m(2) (stage 3a), and 30 to 44 mL per min per 1.73 m(2) (stage 3b). FFR after stent implantation (post-stent FFR) was significantly lower in the stage 3b group than in both the stage 0-2 group and the stage 3a group (P < 0.01). Post-stent FFR had a significant positive correlation with eGFR (r = 0.223, P = 0.024). Multivariate analysis demonstrated that eGFR was an independent predictor of post-stent FFR.<br />Conclusions: Moderate CKD was independently associated with insufficient improvement of FFR after stent implantation. This can partly explain the poor prognosis of patients with CKD. © 2015 Wiley Periodicals, Inc.<br /> (© 2015 Wiley Periodicals, Inc.)
- Subjects :
- Aged
Angina, Stable complications
Angina, Stable diagnostic imaging
Angina, Stable physiopathology
Cardiac Catheterization
Coronary Angiography
Coronary Artery Disease complications
Coronary Artery Disease diagnostic imaging
Coronary Artery Disease physiopathology
Coronary Vessels diagnostic imaging
Female
Glomerular Filtration Rate
Humans
Male
Middle Aged
Multivariate Analysis
Percutaneous Coronary Intervention adverse effects
Recovery of Function
Renal Insufficiency, Chronic diagnosis
Renal Insufficiency, Chronic physiopathology
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Angina, Stable therapy
Coronary Artery Disease therapy
Coronary Vessels physiopathology
Drug-Eluting Stents
Fractional Flow Reserve, Myocardial
Kidney physiopathology
Percutaneous Coronary Intervention instrumentation
Renal Insufficiency, Chronic complications
Subjects
Details
- Language :
- English
- ISSN :
- 1522-726X
- Volume :
- 88
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
- Publication Type :
- Academic Journal
- Accession number :
- 26489880
- Full Text :
- https://doi.org/10.1002/ccd.26258