Renal Function and Coronary Bypass Surgery in Patients With Ischemic Heart Failure

Abstract Objective Chronic kidney disease (CKD) is a known risk factor in cardiovascular (CV) disease but its influence on treatment effect of bypass surgery (CABG) remains unclear. We assessed the influence of CKD on 10-year mortality and CV-outcomes in ischemic HF patients treated with medical therapy (MED) with or without CABG. Methods We calculated baseline estimated glomerular filtration rate (eGFR, CKD-EPI formula, CKD stages 1-5) from 1,209 patients randomized to MED or CABG in the Surgical Treatment for IsChemic Heart failure (STICH) trial and assessed its effect on outcome. Results In the overall STICH cohort, patients in CKD stages 3-5 were older than those in stages 1/2 (66-71 vs. 54-59 years) and had more comorbidities. Multivariable modeling revealed an inverse association between eGFR and risk of death, CV death and/or CV-rehospitalization (all p Conclusions Chronic kidney disease is an independent risk factor for mortality in patients with ischemic HF with or without CABG. However, mild to moderate CKD does not appear to influence long-term treatment effects of CABG.