Renal function and non-coronary atherosclerosis progression in patients with coronary artery disease one year after coronary artery bypass

Abstract

Aim. To study associations of the estimated glomerular filtration rate (eGFR) with non-coronary atherosclerosis progression criteria and risk factors one year after coronary bypass surgery (CABG).Material and methods. Of the 732 patients consecutively operated (586 men and 146 women, median age 59 years), 504 people visited the study center 1 year after CABG. At the preoperative and annual stages, all patients were assessed with the same set of clinical, instrumental and laboratory methods, and the ankle-brachial index (ABI) was measured. The eGFR was calculated by the CKD-EPI formula. Depending on the severity of non-cardiac arterial stenoses, the following groups were identified: <30%; 30-49%; 50-69%; 70-99%; occlusion; absence of stenosis. The criteria for the atherosclerosis progression was the presence of at least one of the following: the transition of stenosis from one group to another; decrease in initially normal ABI <0,9; decrease in ABI initially abnormal (<0,9) by more than 10%. For the analysis, two groups were identified: group 1 (n=375) without progression and group 2 (n=129) with progression of atherosclerosis.Results. Preoperatively, the number of patients with eGFR <60 ml/min/1,73 m2 was equal in both groups. At both control points, eGFR was higher in 1 group (p=0,072 and 0,025, respectively). During the year, eGFR increased in both groups with significant differences among first one (p<0,001). One year after the operation, eGFR positively correlated with ABI (p=0,004) and with total and low-density lipoprotein cholesterol levels. Polyvascular disease determined from 30% of stenosis, was negatively associated with preoperative and annual eGFR (p=0,011 and p=0,004, respectively) and from 50% — with eGFR calculated one year after CABG (p=0,006).Conclusion. In patients with progression of non-coronary atherosclerosis 1 year after CABG CKD-EPI eGFR was lower compared to patients without progression. In the long-term period the estimated values of renal function are significantly higher in patients without atherosclerosis progression.

Keywords

• coronary artery bypass
• renal dysfunction
• estimated glomerular filtration rate
• atherosclerosis progression