Impact of Chronic Kidney Disease and Anemia on Outcomes After Percutaneous Coronary Revascularization

Area of Science:

• Cardiology
• Nephrology
• Hematology

Background:

• Percutaneous coronary intervention (PCI) is a common procedure for coronary artery disease.
• Anemia and chronic kidney disease (CKD) are prevalent comorbidities that can affect cardiovascular outcomes.
• Limited data exist on the combined impact of anemia and CKD on patients undergoing PCI.

Purpose of the Study:

• To evaluate the individual and combined effects of anemia and CKD on outcomes after PCI.
• To compare mortality, readmission, and reintervention rates in patients with different combinations of anemia and CKD.

Main Methods:

• Retrospective analysis of 10,756 patients who underwent PCI between 2010 and 2018.
• Exclusion of patients with ST-elevation myocardial infarction or shock.
• Multivariate analysis to assess the adjusted hazard ratios for mortality, readmission, and reintervention.

Main Results:

• Five-year mortality was highest in patients with both anemia and CKD (adjusted hazard ratio 2.83).
• Patients with anemia alone (aHR 1.68) and CKD alone (aHR 1.33) also had increased mortality compared to those with neither condition.
• Similar trends of increased risk for readmission and reintervention were observed in patients with both anemia and CKD.

Conclusions:

• The combined presence of anemia and CKD significantly increases adverse outcomes, including mortality, after PCI.
• The synergistic effect of anemia and CKD on post-PCI outcomes is more detrimental than either condition alone.
• These findings highlight the importance of managing both anemia and CKD in patients undergoing PCI.