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Percutaneous coronary intervention-associated nephropathy foreshadows increased risk of late adverse events in

Joseph Lindsay1, Sue Apple, Ellen E Pinnow

  • 1Department of Cardiology, Washington Hospital Center, Washington, D.C.,USA. joseph.m.lindsay@medstar.net

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|June 25, 2003
PubMed

Insights

Decline in renal function after percutaneous coronary intervention (PCI) in patients with normal kidney function is rare but significantly increases the risk of 1-year mortality and myocardial infarction.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Decline in renal function (DRF) post-percutaneous coronary intervention (PCI) is a known risk factor for adverse outcomes in patients with chronic renal insufficiency.
  • The risk associated with DRF in patients with previously normal renal function after PCI is less understood.

Purpose of the Study:

  • To investigate whether patients with normal renal function developing DRF after PCI face a comparable increased risk of death and myocardial infarction at 1 year.
  • To determine if this risk is independent of in-hospital complications.

Main Methods:

  • Retrospective analysis of 5,967 patients undergoing successful PCI with normal pre-PCI serum creatinine (SCr) and no prior renal insufficiency.
  • Exclusion of patients with major in-hospital complications.
  • 1-year follow-up for mortality and myocardial infarction.

Main Results:

  • 3.5% of patients (208) developed DRF (SCr increase ≥50%).
  • Patients with DRF were older, more likely female, non-Caucasian, diabetic, hypertensive, and had more prior vascular events.
  • DRF was an independent predictor of 1-year mortality, myocardial infarction, and target vessel revascularization after adjustment for baseline variables.

Conclusions:

  • In patients without prior renal impairment, DRF post-PCI is uncommon but significantly elevates the risk of late adverse cardiac events.
  • The increased risk of mortality and myocardial infarction associated with DRF in this population is comparable to that observed in patients with chronic renal insufficiency.

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