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Serum creatinine ratio: a novel predictor of mortality after percutaneous coronary intervention in patients with

Annapoorna S Kini1, Kunal Sarkar, Oana C Rafael

  • 1Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, New York 10029-6574, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|March 17, 2009
PubMed

Insights

A serum creatinine ratio greater than 1.5 after percutaneous coronary intervention predicts one-year mortality in patients with and without chronic renal insufficiency. This finding aids in risk stratification for patients undergoing revascularization procedures.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Medicine

Background:

  • Contrast-induced nephropathy (CIN) increases mortality post-percutaneous revascularization.
  • The impact of varying creatinine elevation levels on mortality in chronic renal insufficiency (CRI) patients is unclear.
  • The relationship between post-PCI creatinine rise and mortality in patients with normal baseline renal function requires investigation.

Purpose of the Study:

  • To investigate the correlation between different serum creatinine (SCr) elevation levels and 1-year mortality after percutaneous coronary intervention (PCI).
  • To determine if this correlation differs between patients with chronic renal insufficiency (CRI) and those with normal baseline renal function.

Main Methods:

  • Analysis of 12,997 PCI patients, divided into CRI (baseline SCr ≥ 1.5 mg/dl) and normal baseline renal function (BSC < 1.5 mg/dl) groups.
  • Patients were subgrouped by serum creatinine ratio (SCrR = peak SCr/Baseline SCr): <1.25, 1.25-1.5, and >1.5.
  • Cox hazard modeling was used to assess variables associated with 1-year mortality.

Main Results:

  • Overall CIN incidence was 5.9% (11.3% in CRI vs. 5.1% in normal BSC group).
  • Only SCrR > 1.5 was significantly correlated with increased 1-year mortality.
  • This association was consistent in both CRI and normal baseline renal function groups.

Conclusions:

  • A serum creatinine ratio (SCrR) greater than 1.5 is a predictor of 1-year mortality following PCI.
  • This predictive value holds for patients with both chronic renal insufficiency and normal baseline renal function.
  • SCrR serves as a valuable tool for risk stratification and prognostication in post-PCI patients.
Abstract

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