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Journal of Cardiothoracic Surgery

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Open Access 01-12-2021 | CABG | Research article

The predictive value of creatinine clearance for mortality in patients undergoing revascularization

Authors: Eilon Ram, Pazit Beckerman, Amit Segev, Nir Shlomo, Abigail Atlas-Lazar, Leonid Sternik, Ehud Raanani

Published in: Journal of Cardiothoracic Surgery | Issue 1/2021

Abstract

Background

Renal function plays a significant role in the prognosis and management of patients with multi-vessel coronary artery disease (CAD) referred for revascularization. Current data lack precise risk stratification using estimated glomerular filtration rate (eGFR) and creatinine clearance.

Methods

This prospective study includes a three-year follow-up of 1112 consecutive patients with multi-vessel CAD enrolled in the 22 hospitals in Israel that perform coronary angiography.

Results

The Mayo formula yielded the highest mean eGFR (90 ± 26 mL/min per 1.73m²) and chronic kidney disease-epidemiology collaboration (CKD-EPI) the lowest (76 ± 24 mL/min per 1.73m²). Consequently, the Mayo formula classified more patients (56%) as having normal renal function. There was a significant and strong correlation between the values obtained from all five formulas using Cockcroft-Gault as the reference formula: Mayo: r = 0.80, p < 0.001; CKD-EPI: r = 0.87, p < 0.001; modification of diet in renal disease (MDRD): r = 0.84, p < 0.001; inulin clearance-based: r = 0.99, p < 0.001). Multivariable analysis demonstrated that decreased renal function is an independent predictor of 3-year mortality in all five formulas, with risk increasing by 15–25% for each 10-unit decrease in eGFR. Despite the similarities between the formulas, the ability to predict mortality was highest in the Mayo formula and lowest in MDRD.

Conclusions

Our data suggest that while the Mayo formula is not currently recommended by any nephrology guidelines, it may be an alternative formula to predict mortality among patients with multivessel CAD, including to the widely used MDRD formula.

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Title: The predictive value of creatinine clearance for mortality in patients undergoing revascularization
Authors: Eilon Ram
Pazit Beckerman
Amit Segev
Nir Shlomo
Abigail Atlas-Lazar
Leonid Sternik
Ehud Raanani
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: CABG
Chronic Kidney Disease
CABG
Published in: Journal of Cardiothoracic Surgery / Issue 1/2021
Electronic ISSN: 1749-8090
DOI: https://doi.org/10.1186/s13019-021-01502-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The predictive value of creatinine clearance for mortality in patients undergoing revascularization

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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