The Estimated Glomerular Filtration Rate in the Prediction of Major Adverse Cardiovascular Events in Patients with Normal Renal Function after Coronary Artery Bypass Grafting: A Single-Center Retrospective Cohort Study

Background: The estimated glomerular filtration rate (eGFR) has emerged as a risk factor for coronary artery disease (CAD), but there are currently insufficient data on the association of eGFR with the postoperative prognosis in patients undergoing coronary artery bypass grafting (CABG). This study aimed to investigate the potential utility of eGFR as a prognostic indicator for major adverse cardiovascular events (MACE) in patients with normal renal function after CABG. Methods: This study included a total of 222 consecutive patients with normal renal function (eGFR ≥90 mL/min/1.73 m2) who underwent CABG between June 2018 and December 2019. These patients were divided into two groups based on the occurrence of MACE: without MACE group (n = 202) and with MACE group (n = 20). The eGFR was calculated from serum creatinine (SCr). The eGFR (mL/min/1.73 m2) = 175 × SCr (mg/dL)–1.234 × age (year)–0.179 × 0.79 (in the case of females). Kaplan–Meier survival curve analysis was conducted followed by the log-rank test. Cox proportional hazards regression models were used to explore the association between the eGFR and MACE. Receiver operating characteristics (ROC) curve analysis was performed to assess the predictive performance of the eGFR and identify the optimal cutoff point. Results: A progressively lower eGFR was associated with an increasingly higher cumulative incidence of MACE (log-rank test, p = 0.017). The hazard ratio (95% CI) of MACE was 0.068 (0.005–0.941) in tertile 3 of the eGFR and 0.204 (0.051–0.817) per SD increase in the eGFR. The AUC of the eGFR was 0.678 (p = 0.009) and the optimal cut-off value to predict MACE was >118.3 mL/min/1.73 m2. Conclusion: The eGFR may be an independent prognostic determinant in patients with normal renal function undergoing CABG surgery. In patients with normal renal function, MACE was more likely to occur in patients with lower eGFR compared with those with higher eGFR. The eGFR may have an important predictive value in predicting MACE in patients with normal renal function undergoing CABG surgery.