Abstract
Objective and Methods: The aim of this study was to retrospectively analyze the renal prognosis of elderly coronary artery disease (CAD) patients complicated with renal insufficiency.Results: A total of 307 patients were included. The mean follow-up period was 25±11months. The average age was 79±7 years. In the worsening renal function group, there were higher occurrence rate of heart failure and severe coronary artery stenosis, lower rate of percutaneous coronary intervention, lower medication rate of renin-angiotensin blocker, lower plasma albumin, magnesium and hemoglobulin level. There was no significant difference in the rate of worsening renal function or gastrointestinal bleeding between patients who took anti-platelet agents/statins and those without. Patients with reduced left ventricular ejective fraction had higher rate of worsening renal function, yet lower medication rate of renin-angiotensin blockers, lower plasma albumin and hemoglobulin level. Anemia, malnutrition and worsening cardiac function were risk factors of renal function deterioration and mortality.Conclusions: In the elderly coronary artery disease patients who had renal insufficiency, antiplatelet agents and statin have non-adverse effects on renal function; lower medication rate of renin-angiotensin blocker were found in patients with either worsening renal function or heart failure. Anemia, malnutrition and worsening cardiac function are risk factors of renal function deterioration and mortality.
Highlights
Along with the aged trend in the country, there is an increase in the incidence of chronic kidney disease (CKD) estimated to affect more than 11% of elderly populations in China [1]
In the elderly coronary artery disease patients who had renal insufficiency, antiplatelet agents and statin have non-adverse effects on renal function; lower medication rate of renin-angiotensin blocker were found in patients with either worsening renal function or heart failure
It is still unknown about renal prognosis and risks of mortality in elderly coronary artery disease patients complicated with renal insufficiency
Summary
Along with the aged trend in the country, there is an increase in the incidence of chronic kidney disease (CKD) estimated to affect more than 11% of elderly populations in China [1]. A meta-analysis of antiplatelet therapy in chronic kidney disease patients with coronary artery disease showed a decrease in myocardial infarction and no difference in cardiovascular death, but a 1.7-fold increase in minor bleeding risk [4]. Trial data showed that renin-angiotensin www.aging-us.com blocker may prevent cardiovascular events in chronic kidney disease patients [6]. It is still unknown about renal prognosis and risks of mortality in elderly coronary artery disease patients complicated with renal insufficiency. This study focuses on analyzing retrospectively the data about the medication of statins, antiplatelet therapy and reninangiotensin blocker in elderly coronary artery disease (CAD) patients complicated with renal insufficiency, the risk factors of renal prognosis and mortality
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