PMID- 32690359
OWN - NLM
STAT- MEDLINE
DCOM- 20210714
LR  - 20210714
IS  - 1444-2892 (Electronic)
IS  - 1443-9506 (Linking)
VI  - 30
IP  - 2
DP  - 2021 Feb
TI  - Impact of Preoperative Occult Renal Dysfunction on Early and Late Outcomes After 
      Off-Pump Coronary Artery Bypass.
PG  - 288-295
LID - S1443-9506(20)30275-4 [pii]
LID - 10.1016/j.hlc.2020.05.105 [doi]
AB  - BACKGROUND: Renal dysfunction is independently associated with increased early 
      and late mortality after coronary artery bypass graft (CABG) surgery. Off-pump 
      CABG (OPCABG) avoids postoperative complications from the cardiopulmonary bypass, 
      but it is unclear how it is impacted by occult renal dysfunction (ORD). This 
      study aimed to investigate the effects of ORD on early and late outcomes after 
      OPCABG. METHODS: This retrospective and observational cohort study reviewed data 
      on 1,188 patients who underwent first isolated OPCABG with normal serum 
      creatinine (SCr) levels. According to preoperative estimated creatinine clearance 
      (eCrCl) by the Cockcroft-Gault formula, the patients were divided into an ORD 
      group (n=260, eCrCl <60 mL/min/1.73 m(2)) and a control group (n=928, eCrCl >/=60 
      mL/min/1.73 m(2)). RESULTS: The ORD patients presented with older age, higher 
      incidence of small body surface area, hypertension, low preoperative eCrCl, 
      cerebrovascular accident, peripheral vascular disease, New York Heart Association 
      (NYHA) Ⅲ, and high risk score. The prevalence of hospital mortality, 
      postoperative acute kidney injury (AKI), peak postoperative SCr, and prolonged 
      hospital stay were greater in the ORD patients than the control patients. 
      Multivariable logistic regression analysis showed that the ORD patients were at 
      significantly higher risk of postoperative AKI (OR, 2.702; 95% CI, 1.994-3.662) 
      and in-hospital mortality (OR, 2.884; 95% CI, 1.293-6.432). Multivariate Cox 
      proportional hazard models confirmed that ORD was significantly associated with 
      high later mortality (HR, 2.847; 95% CI, 1.262-6.425). CONCLUSIONS: Occult renal 
      dysfunction is an independent risk factor for postoperative AKI in-hospital and 
      later mortality in patients undergoing OPCABG with normal SCr levels.
CI  - Copyright (c) 2020. Published by Elsevier B.V.
FAU - Lv, Mengwei
AU  - Lv M
AD  - Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai 
      East Hospital, Tongji University School of Medicine, Shanghai, P. R. China; The 
      Shanghai East Clinical Medical College of Nanjing Medical University, Shanghai, 
      P. R. China.
FAU - Hu, Bo
AU  - Hu B
AD  - Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai 
      East Hospital, Tongji University School of Medicine, Shanghai, P. R. China.
FAU - Ge, Wen
AU  - Ge W
AD  - Department of Cardiothoracic Surgery, Shuguang Hospital, affiliated to Shanghai 
      University of TCM, Shanghai, P. R. China.
FAU - Li, Zhi
AU  - Li Z
AD  - Department of Cardiovascular Surgery, Jiangsu Province Hospital, The First 
      Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, P. R. 
      China.
FAU - Wang, Qi
AU  - Wang Q
AD  - The Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu, P. 
      R. China.
FAU - Han, Chunyan
AU  - Han C
AD  - Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University 
      School of Medicine, Shanghai, P. R. China.
FAU - Liu, Ban
AU  - Liu B
AD  - Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University 
      School of Medicine, Shanghai, P. R. China; Department of Cardiology, Shanghai 
      Tenth People's Hospital Chongming Branch, Tongji University School of Medicine, 
      Shanghai, P. R. China. Electronic address: 2013liuban@tongji.edu.cn.
FAU - Zhang, Yangyang
AU  - Zhang Y
AD  - Key Laboratory of Arrhythmias of the Ministry of Education of China, Shanghai 
      East Hospital, Tongji University School of Medicine, Shanghai, P. R. China; The 
      Shanghai East Clinical Medical College of Nanjing Medical University, Shanghai, 
      P. R. China; Department of Cardiovascular Surgery, Shanghai East Hospital, Tongji 
      University School of Medicine, Shanghai, P. R. China. Electronic address: 
      zhangyangyang_wy@vip.sina.com.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
DEP - 20200624
PL  - Australia
TA  - Heart Lung Circ
JT  - Heart, lung & circulation
JID - 100963739
SB  - IM
MH  - Acute Kidney Injury/*etiology/physiopathology
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Coronary Artery Bypass, Off-Pump/*adverse effects
MH  - Coronary Artery Disease/*surgery
MH  - Female
MH  - Glomerular Filtration Rate/*physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Postoperative Complications
MH  - Preoperative Period
OTO - NOTNLM
OT  - Coronary artery bypass grafting
OT  - Mortality
OT  - Off-pump
OT  - Prognosis
OT  - Renal dysfunction
EDAT- 2020/07/22 06:00
MHDA- 2021/07/15 06:00
CRDT- 2020/07/22 06:00
PHST- 2019/02/27 00:00 [received]
PHST- 2019/07/29 00:00 [revised]
PHST- 2020/05/24 00:00 [accepted]
PHST- 2020/07/22 06:00 [pubmed]
PHST- 2021/07/15 06:00 [medline]
PHST- 2020/07/22 06:00 [entrez]
AID - S1443-9506(20)30275-4 [pii]
AID - 10.1016/j.hlc.2020.05.105 [doi]
PST - ppublish
SO  - Heart Lung Circ. 2021 Feb;30(2):288-295. doi: 10.1016/j.hlc.2020.05.105. Epub 
      2020 Jun 24.