Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention

Area of Science:

• Cardiology
• Nephrology
• Interventional Cardiology

Background:

• The incidence and prognostic impact of acute renal failure (ARF) following percutaneous coronary intervention (PCI) in contemporary practice remain unclear.
• Understanding ARF risks is crucial for patient management and outcomes after PCI.

Purpose of the Study:

• To determine the incidence, risk factors, and prognostic implications of ARF after PCI.
• To identify patient subgroups at higher risk for ARF.

Main Methods:

• Retrospective analysis of the Mayo Clinic PCI registry.
• Inclusion of 7586 patients undergoing PCI.
• Definition of ARF as an increase in serum creatinine >0.5 mg/dL from baseline.

Main Results:

• ARF occurred in 3.3% of patients (254/7586).
• Risk factors included baseline serum creatinine, acute myocardial infarction, shock, and contrast volume.
• Diabetic patients with baseline creatinine <2.0 mg/dL had higher ARF risk; all patients with baseline creatinine >2.0 mg/dL were at high risk.
• ARF was associated with significantly increased in-hospital (22% vs 1.4%) and long-term mortality (1-year: 12.1% vs 3.7%; 5-year: 44.6% vs 14.5%).

Conclusions:

• The overall incidence of ARF post-PCI is low.
• Specific patient groups, including diabetics with baseline creatinine <2.0 mg/dL and all with baseline creatinine >2.0 mg/dL, are at elevated risk.
• ARF is a strong predictor of mortality during hospitalization and long-term follow-up.