DOI: http://dx.doi.org/10.18203/2349-2902.isj20202849

Ramifications of coronary angiography with effect to time comparing two groups: undergoing off pump coronary artery bypass grafting within or more than seven days of coronary angiography

Manpal Loona, T. S. Mahant

Abstract


Background: Acute kidney injury (AKI) following off pump coronary artery bypass grafting (OPCABG) within short interval from coronary angiography (CAG) has been well documented. This prospective study is aimed to delineate perioperative effects and effects of elective 7 days interval between CAG and off pump CABG, to observe its outcome on renal functions.

Methods: The present study was conducted in a total of 1102 consecutive patients who underwent coronary angiography following coronary artery bypass surgery in Fortis hospital, Mohali. Patients were divided into 2 groups - group A (patients undergoing CABG within 7 days of CAG) and group B (patients undergoing CABG beyond 7 days of CAG). Comparison was made between the two groups, in relation to the timing between CAG and CABG, with its impact on perioperative renal functions.

Results: Statistically it was found highly significant higher values of 1st and 3rd day serum creatinine and high incidence of postoperative AKI in patients of group A in comparison to patients of group B.

Conclusions: Thus, our study confirms that patients with a shorter interval between CAG and subsequent OPCAB are more likely to present higher peak creatinine level as well as lower minimum eGFR. A gap of 7 days for elective cases is more likely to present less postoperative AKI.


Keywords


Off pump coronary artery bypass grafting, Acute kidney injury, Peri-operative renal functions, Time interval between CAG and CABG

Full Text:

PDF

References


Chertow GM, Levy EM, Hammermeister KE, Grover F, Daley J. Independent association between acute renal failure and mortality following cardiac surgery. Am J Med. 1998;104:343-8.

Oda T. Acute kidney injuries after off-pump coronary artery bypass grafting. Circ J. 2010;74:1069-70.

Lassnigg A, Schmidlin D, Mouhieddine M, Bachmann LM, Druml W, Bauer P, et al. Minimal changes of serum creatinine predict prognosis in patients after cardiothoracic surgery: a prospective cohort study. J Am Soc Nephrol. 2004;15:1597-605.

Ryckwaert F, Boccara G, Frappier JM, Colson PH. Incidence, risk factors, and prognosis of a moderate increase in plasma creatinine early after cardiac surgery. Crit Care Med. 2002;30(7):1495-8.

Rosner MH, Okusa MD. Acute kidney injury associated with cardiac surgery. Clin J Am Soc Nephrol. 2006;1(1):19-32.

Loef BG, Epema AH, Navis G, Ebels T, Oeveren VW, Henning RH. Off-pump coronary revascularization attenuates transient renal damage compared with on-pump coronary revascularization. Chest. 2002;121(4):1190-4.

Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation: Modification of Diet in Renal Disease Study Group. Ann Intern Med. 1999;130:461-70.

Chertow GM, Lazarus JM, Christiansen CL, Cook EF, Hammermeister KE, Grover F, et al. Preoperative renal risk stratification. Circulation. 1997;95(4):878-84.

Duca DD, Iqbal S, Rahme E, Goldberg P, Varennes DB. Renal failure after cardiac surgery: timing of cardiac catheterization and other perioperative risk factors. Ann Thorac Surg. 2007;84(4):1264-71.

Medalion B, Cohen H, Assali A, Assa VH, Farkash A, Snir E, et al. The effects of cardiac angiography timing, contrast media dose, and preoperative renal function on acute renal failure after coronary artery bypass grafting. J Thorac Cardiovasc Surg. 2010;139(6):1539-44.

Ji Q, Mei Y, Wang X, Feng J, Wusha D, Cai J, et al. Effect of elapsed time from coronary angiography until off-pump coronary artery bypass surgery on postoperative renal function. Circ J. 2012;76(10):2356-62.