Prognostic Value of Renal Function for Cardiac Events in Patients Without Significant Stenosis on Coronary Computed Tomography Angiography

• Published in: Journal of Korean medical science Vol. 30; no. 9; pp. 1273 - 1278
• Main Authors: Kim, Hack-Lyoung, Kim, Yong-Jin, Yoon, Yeonyee E., Lee, Seung-Pyo, Kim, Hyung-Kwan, Cho, Goo-Yeong, Zo, Joo-Hee, Choi, Dong-Ju, Sohn, Dae-Won
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 01.09.2015; 대한의학회
• Subjects: Adult; Aged; Aged, 80 and over; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - mortality; Comorbidity; Coronary Angiography - statistics & numerical data; Coronary Stenosis - diagnostic imaging; Coronary Stenosis - mortality; Female; Humans; Incidence; Kidney Diseases - diagnosis; Kidney Diseases - mortality; Kidney Function Tests - statistics & numerical data; Male; Middle Aged; Original; Prognosis; Reproducibility of Results; Republic of Korea - epidemiology; Risk Assessment; Sensitivity and Specificity; Survival Rate; Tomography, X-Ray Computed - statistics & numerical data; 의학일반; Multidetector Computed Tomography; Creatinine Clearance; Prognosis; Coronary Artery Disease
• ISSN: 1011-8934; 1598-6357
• DOI: 10.3346/jkms.2015.30.9.1273

This study was conducted to determine clinical parameters predicting future major adverse cardiovascular events (MACEs) in patients without significant stenosis on coronary computed tomographic angiography (CCTA). A total of 625 patients with suspected coronary artery disease (CAD) who underwent CCTA that revealed insignificant (< 50%) CAD was reviewed in three cardiac centers. The MACEs including cardiac death, non-fatal myocardial infarction (MI), unstable angina and late (> 90 days after CCTA) revascularization were assessed. During the mean follow-up period of 819 ± 529 days (median 837 days), there were 28 cases of MACEs (4.5%). In multivariable Cox regression analysis, independent predictors for MACEs were male sex (hazard ratio [HR], 2.40; 95% confidence interval [CI], 1.01-5.69; P = 0.046) and low estimated creatinine clearance (eCCr) (< 60 mL/min/1.73 m(2)) (HR, 3.07; 95% CI, 1.22-7.74; P = 0.017). Low eCCr was the only independent predictor for hard events including cardiac death and MI (HR, 17.6, 95% CI, 1.44-215.7; P = 0.025). In conclusion, renal function is an independent predictor for cardiovascular events among patients without significant CAD by CCTA. Careful monitoring and preventive strategy are warranted in patients with impaired renal function even without significant CAD.