Faculty Collaboration Database

Renal insufficiency is an independent predictor of mortality after percutaneous coronary intervention. Am J Cardiol 2003 Nov 15;92(10):1160-4

Date

11/12/2003

Pubmed ID

14609589

DOI

10.1016/j.amjcard.2003.07.023

Scopus ID

2-s2.0-0242492314 (requires institutional sign-in at Scopus site)   113 Citations

Abstract

The present study was designed to evaluate whether the presence of renal disease during percutaneous coronary intervention (PCI) is associated with worse outcomes at 1 year in a multicenter study. The incidence of death, myocardial infarction, coronary artery bypass grafting, repeat PCI, and repeat revascularization were prospectively collected on 4,602 patients (6,542 lesions) in 2 waves of patients who underwent PCI in 17 centers between July 1997 and June 1999. Renal disease was defined as the presence of an increased creatinine level in a patient with a history or presence of renal failure treated with low protein diet or dialysis. Patients with renal disease (n = 192) were older and more likely to have diabetes, heart failure, reduced ejection fraction, known coronary disease, and multivessel disease than patients without renal disease (n = 4,410). Rates of stenting were equivalent (68.2% vs 73.0%, p = NS). Patients with renal disease had lower angiographic success (84.9% vs 92.8%, p <0.001) and higher mortality, both in-hospital (5.7% vs 1.2%, p <0.001) and at 1 year (19.7% vs 4.4%, p <0.0001). After adjusting for clinical, demographic, and angiographic differences, renal disease remained an independent predictor of in-hospital (odds ratio 3.81, 95% confidence interval 1.70 to 8.58) and 1-year (risk ratio 2.46, 95% confidence interval 1.64 to 3.68) mortality. Renal disease conferred additional mortality risk in established high-risk clinical subgroups. In conclusion, after adjusting for a higher frequency of co-morbidities, renal disease remains a strong and independent predictor of increased in-hospital and 1-year mortality after PCI and is additive to other clinical markers of worse outcome.

Author List

Naidu SS, Selzer F, Jacobs A, Faxon D, Marks DS, Johnston J, Detre K, Wilensky RL

Author

David S. Marks MD Vice Chair, Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Coronary Stenosis
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction
Predictive Value of Tests
Prospective Studies
Renal Insufficiency
Risk Factors
Survival Rate
Time Factors
Treatment Outcome