Prognostic value of cardiopulmonary exercise testing in patients with coronary artery disease with different renal function
Objective To investigate the prognostic value of cardiopulmonary exercise testing(CPET)in patients with coronary artery disease(CAD)with different renal status.Methods 5 087 CAD patients who completed CPET from February 2016 to December 2021 in the Department of Cardiology of General Hospital of Northern Theater Command were selected as the study objects.According to the estimated glomerular filtration rate(eGFR)at admission,patients were divided into normal renal function group(eGFR≥60 ml/min,n =4 969)and abnormal renal function group(eGFR<60 ml/min,n =118).Demographic characteristics,past medical history,labora-tory test results,medication history and CPET results of the two groups of patients were collected.Major adverse cardiovascular events(MACE)were recorded in both groups.Multivariate COX regression analysis was used to evaluate cardiopulmonary function and its correlation with prognosis in CAD patients with different renal status.Results After matching,the peak heart rate,peak oxygen uptake and peak metabolic equivalent of patients in the abnormal renal function group were lower than those in the normal renal function group,and the oxygen ventilation equivalent and heart rate reserve were higher than those in the normal renal function group,with statistical significance(P<0.05).After matching,there was no statistical significance in the incidence of clinical outcome events between the two groups(P>0.05).Multivariate COX regression analysis showed that smoking history,hypertension grade,previous percutaneous coronary intervention(PCI),creatine kinase isoenzyme,N-terminal pro-B-type natriuretic peptide,peak oxygen uptake and oxygen ventilation equivalent were all influencing factors of MACE in the overall study population(P<0.05).In the patients with normal renal function,smoking history,hypertension grade,previous PCI,creatine kinase isoenzyme,peak oxygen uptake and oxygen ventilation equivalent were the influencing factors of MACE(P<0.05).In the patients with renal dysfunction,smoking history,hyper-tension grade,ejection fraction and peak oxygen uptake were the influencing factors of MACE(P<0.05).Conclusion For patients with normal renal function,peak oxygen uptake and oxygen ventilation equivalent can predict the prognosis of CAD patients.For pa-tients with abnormal renal function,peak oxygen uptake has predictive value for prognosis of CAD patients.
NETL
NSTL
万方数据
