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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  ;  노현정  ;  박형천  ;  강남규  ;  최동훈  ;  강신욱  ;  장양수  ;  신원흠  ;  조승연  ;  이호영  ;  한대석  ;  최규헌 
Citation
 Korean Journal of Nephrology (대한신장학회지), Vol.20(4) : 675-682, 2001 
Journal Title
 Korean Journal of Nephrology  (대한신장학회지) 
ISSN
 1225-0015 
Issue Date
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
https://ir.ymlib.yonsei.ac.kr/handle/22282913/142389
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
박형천(Park, Hyeong Cheon)
최규헌(Choi, Kyu Hun)
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