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Titolo:
Angiographic progression of coronary artery disease in patients with end-stage renal disease
Autore:
Gradaus, F; Ivens, K; Peter, AJ; Heering, P; Schoebel, FC; Grabensee, B; Strauer, BE;
Indirizzi:
Univ Dusseldorf, Klin Kardiol Pneumol & Angiol, D-40225 Dusseldorf, Germany Univ Dusseldorf Dusseldorf Germany D-40225 , D-40225 Dusseldorf, Germany Univ Dusseldorf, Klin Nephrol & Rheumatol, D-40225 Dusseldorf, Germany Univ Dusseldorf Dusseldorf Germany D-40225 , D-40225 Dusseldorf, Germany
Titolo Testata:
NEPHROLOGY DIALYSIS TRANSPLANTATION
fascicolo: 6, volume: 16, anno: 2001,
pagine: 1198 - 1202
SICI:
0931-0509(200106)16:6<1198:APOCAD>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOVASCULAR RISK-FACTORS; CHRONIC DIALYSIS PATIENTS; HEMODIALYSIS-PATIENTS; DIABETIC-PATIENTS; ATHEROSCLEROSIS; ANGIOPLASTY; FAILURE; TERM; HYPERHOMOCYSTEINEMIA; COMPLICATIONS;
Keywords:
angiography; coronary artery disease; cardiovascular mortality; end-stage renal disease; morphological progression;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
27
Recensione:
Indirizzi per estratti:
Indirizzo: Gradaus, F Univ Dusseldorf, Klin Kardiol Pneumol & Angiol, Moorenstr 5, D-40225 Dusseldorf, Germany Univ Dusseldorf Moorenstr 5 Dusseldorf Germany D-40225 Germany
Citazione:
F. Gradaus et al., "Angiographic progression of coronary artery disease in patients with end-stage renal disease", NEPH DIAL T, 16(6), 2001, pp. 1198-1202

Abstract

Background. Patients with end-stage renal disease have an increased risk of developing coronary artery disease (CAD). The cardiovascular mortality ofdialysis patients is 10-15 times higher compared with the general population. The aim of our study was to evaluate the morphological progression of coronary arteriosclerosis in this cardiovascular high-risk group by visual assessment and quantitative coronary angiography. Methods and results. In 26 patients with chronic renal failure (age. 47+/-11 years: 15 male: duration of dialysis, 23 +/- 25 months) the severity of CAD and degree of coronary stenoses were assessed in two coronary angiograms after a mean follow-up interval of 30 +/- 15 months (12-60). Baseline angiography revealed CAD in 13/22 patients (59%). The second angiography was performed as screening procedure prior to renal transplantation (n=20) and/or as follow-up angiography after coronary angioplasty (n = 10). Visual assessment showed a progression defined by the development of haemodynamically relevant stenosis of > 50% luminal diameter in 13 patients. Quantitative angiographic evaluation was performed in a total of 45 segments showing >25% narrowing at the second angiogram. A progression (>15% luminal reduction) was found in 17 of 45 segments, a new lesion (initial luminal diameter < 20%) was detected in nine segments, resulting in progression or new lesion in 16 patients (62%). Patients with or without progression did not differ in age. duration of dialysis treatment, number of cardiovascular risk factors, or serum total cholesterol and fibrinogen levels. After percutaneous transluminal coronary angioplasty (PTCA) a restenosis was seen in seven of 16 primarily successfully dilated segments. After the second angiography, myocardial revascularization was performed in eight patients (1 PTCA, 7 coronary artery bypass graft). Conclusions, Patients with end-stage renal disease have a high prevalence of CAD. In line with the clinical course, CAD patients on maintenance dialysis undergo rapid angiographic progression of CAD, which results in a high rate of subsequent myocardial revascularizations.

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Documento generato il 18/01/20 alle ore 01:46:44