Usefulness of Preoperative Echocardiography to Predict Acute Kidney Injury and Long-Term Mortality after Coronary Artery Bypass Grafting

• Published in: The American journal of cardiology 2017-01, Vol.119 (2), p.231-236
• Main Authors: Han, Seung Seok, MD, PhD, Park, Seokwoo, MD, Kang, Si-Hyuck, MD, Cho, Goo-Yeong, MD, PhD, Kim, Dong Ki, MD, PhD, Kim, Sejoong, MD, PhD, Chin, Ho Jun, MD, PhD, Chae, Dong-Wan, MD, PhD, Na, Ki Young, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - etiology; Acute Kidney Injury - mortality; Adhesion; Adults; Aged; Aorta; Blood circulation; Blood flow; Body height; Body mass; Body mass index; Body weight; Bypasses; Cardiovascular; Cardiovascular diseases; Catheterization; Congestive heart failure; Continuity (mathematics); Coronary artery; Coronary Artery Bypass - adverse effects; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Coronary vessels; Creatinine; Death; Diabetes mellitus; Diagnosis; Doppler effect; Echocardiography; Electronic medical records; End-stage renal disease; Feedback; Female; Health risks; Heart; Heart failure; Heart surgery; Hemodynamics; Humans; Hypertension; Injuries; Intervention; Kidney diseases; Lists; Male; Mercury; Middle Aged; Morbidity; Mortality; Myocardial infarction; Parameter identification; Postoperative Complications - etiology; Postoperative Complications - mortality; Pulmonary arteries; Rats; Regression analysis; Renal function; Retrospective Studies; Risk; Statistical analysis; Statistical significance; Stroke Volume; Surface area; Surgery; Survival; Survival Analysis; Veins & arteries; Velocity; Ventricle
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.09.054

Abstract Acute kidney injury (AKI) is a common complication in patients undergoing coronary artery bypass grafting (CABG), which is associated with significant morbidity and mortality. This study identified echocardiographic predictors of AKI and determined whether these predictors were related to long-term mortality in CABG. This retrospective cohort study included 1,300 patients who underwent echocardiography before CABG at two tertiary referral centers from 2004 to 2010. The best echocardiographic predictor of AKI was determined using multivariate and stepwise selection methods. Patients were followed for 72 ± 28.8 months (maximum 11 years) for all-cause mortality. We measured the adjusted odds ratio (OR) and hazard ratio (HR) for AKI and all-cause mortality, respectively, according to the chosen parameter. E/e’ was the best predictor of AKI among echocardiographic parameters. The high E/e’ group (>15) exhibited a higher OR for AKI [2.2 (1.51–3.27)] than the low E/e’ group (