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말기신부전 환자에서 시행한 관상동맥 조영술 소견과 치료에 대한 고찰

Title
말기신부전 환자에서 시행한 관상동맥 조영술 소견과 치료에 대한 고찰
Other Titles
Coronary Angiographic Findings and Treatment of Coronary Artery Disease in ESRD Patients
Authors
김재헌;윤수영;최규헌;한대석;이호영;조승연;신원흠;장양수;강신욱;최동훈;강남규;박형천;노현정
Issue Date
2001
Journal Title
Korean Journal of Nephrology (대한신장학회지)
ISSN
1225-0015
Citation
Korean Journal of Nephrology (대한신장학회지), Vol.20(4) : 675~682, 2001
Abstract
Background - Disease of the heart remains the leading cause of death in patients treated for endstage renal disease(ESRD). In contrast to person with normal renal function, coronary risk factors or indicators could not yet clearly be defined in renal insufficiency. The aim of this study is to elucidate whether conventional risk factors are valid predictors of coronary artery disease(CAD) in ESRD patients and to examine the therapeutic outcome of percutaneous transluminal coronary angioplasty(PTCA) and coronary artery bypass graft(CABG) in chronic dialysis patients. Methods: Between 1997 and 1999, 44 ESRD patients were perfomed by echocardiography and coronary angiography. Results: 31 patients showed positive results in coronary angiography. In patients with CAD, there were statistically significantly older(45.4 vs 60.6 yrs), had higher LP(a> level(18.0 vs 37.5 mg/dL), lower HDL cholesterol level(42.5 vs 33.6 mg/dL), higher BMI (20.7 vs 22.6), and lesser degree of ejection fraction on echocardiography(58.6Yo vs 42.8Yo). And there were more patients who had DM(30.8 vs 64.5Fo) and previous myocardial infarction(MI) histories(7.796 vs 38.7 96) in CAD group. Logistic regression analysis suggested that old age, high Lp(a), and previous MI history could be risk factors for coronary artery disease in ESRD patients. Among the 31 patients had CAD, 10 in HD and 3 in CAPD group experienced PTCA, and another 2 in HD and 4 in CAPD group experienced CABG. Treatment modality and mortality were not different between the two groups. Follow up angiography were performed in 4 HD patients, and 2 of them had restenosis of previously involved vessels. Conclusion: Old age, previous MI history and high Lp(a) are independent risk factors for the presence of CAD in ESRD patients.
URI

http://ir.ymlib.yonsei.ac.kr/handle/22282913/142389
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
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