Adverse impact of chronic kidney disease on clinical outcomes following percutaneous coronary intervention

Jason E. Bloom, Diem T. Dinh, Samer Noaman, Catherine Martin, Michael Lim, Riley Bachelor, Wayne Zheng, Christopher Reid, Angela Brennan, Jeffrey Lefkovits, Nicholas Cox, Stephen J. Duffy, William Chan

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)

Abstract

Aims: We aimed to assess the impact of the severity of chronic kidney disease (CKD) with long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Methods: We analyzed data on consecutive patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR) from January 2014 to December 2018. Patients were stratified into tertiles of renal function; estimated glomerular filtration (eGFR) ≥60, 30–59 and < 30 ml/min/1.73 m2 (including dialysis). The primary outcome was long-term all-cause mortality obtained from linkage with the Australian National Death Index (NDI). The secondary endpoint was a composite of 30 day major adverse cardiac and cerebrovascular events. Results: We identified a total of 51,480 patients (eGFR ≥60, n = 40,534; eGFR 30–59, n = 9,521; eGFR <30, n = 1,425). Compared with patients whose eGFR was ≥60, those with eGFR 30–59 and eGFR<30 were on average older (77 and 78 vs. 63 years) and had a greater burden of cardiovascular risk factors. Worsening CKD severity was independently associated with greater adjusted risk of long-term NDI mortality: eGFR<30 hazard ratio 4.21 (CI 3.7–4.8) and eGFR 30–59; 1.8 (CI 1.7–2.0), when compared to eGFR ≥60, all p <.001. Conclusion: In this large, multicentre PCI registry, severity of CKD was associated with increased risk of all-cause mortality underscoring the high-risk nature of this patient cohort.

Original languageEnglish
Pages (from-to)E801-E809
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume97
Issue number6
DOIs
Publication statusPublished - 1 May 2021

Keywords

  • ACS/NSTEMI
  • acute myocardial infarction/STEMI
  • chronic renal disease

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