Preoperative Estimated Glomerular Filtration Rate is an Independent Predictor of Late Cardiovascular Morbidity after Mitral Valve Surgery
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- Nakazato Taro
- Division of Cardiovascular Surgery, National Hospital Organization Kure Medical Center, Kure, Hiroshima, Japan
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- Nakamura Teruya
- Division of Cardiovascular Surgery, National Hospital Organization Kure Medical Center, Kure, Hiroshima, Japan
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- Sekiya Naosumi
- Division of Cardiovascular Surgery, National Hospital Organization Kure Medical Center, Kure, Hiroshima, Japan
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- Sawa Yoshiki
- Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Osaka, Japan
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Purpose: Renal dysfunction affects outcomes of cardiac surgery, although its role in mitral valve operation has been limitedly documented.Methods: Two hundred and ten patients who underwent mitral valve operation between 2004 and 2011 were divided into 3 groups according to preoperative estimated glomerular filtration ratio (eGFR): group A (eGFR ≥60 ml/min/1.73 m2, n = 102), group B (eGFR, 59–30 ml/min/1.73 m2, n = 92) and group C (eGFR <30 ml/min/1.73 m2, n = 16).Results: Freedom from all-cause and cardiovascular death at 5 years was 77.2% and 93.0%, respectively. No significant differences existed between the 3 groups. In contrast, there was a significant difference in freedom from major adverse cardiovascular events (MACE) between groups (70.4%, 57.1%, and 42.8% in group A, B, and C, respectively; p = 0.008). By univariate and multivariate analysis, eGFR <60 ml/min/1.73 m2 (HR: 1.92, 95% CI: 1.02–3.68, p = 0.044) and left ventricular ejection fraction <40% (HR: 2.69, 95% CI: 1.17–6.23, p = 0.02) were independent risk factors of MACE, although serum creatinine failed to represent an independent risk factor.Conclusion: Patients who underwent mitral valve surgery had acceptable perioperative and long-term survival, irrespective of preoperative renal function. However, eGFR <60 ml/min/1.73 m2 was an independent predictor of late MACE.
収録刊行物
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- Annals of Thoracic and Cardiovascular Surgery
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Annals of Thoracic and Cardiovascular Surgery 20 (5), 390-397, 2014
Annals of Thoracic and Cardiovascular Surgery 編集委員会
