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Kidney Stone History and Adverse Outcomes After Percutaneous Coronary Intervention

Chao-Han Lai1, Li-Ching Huang2, S Neil Holby3

  • 1Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN; Center for Quantitative Sciences, Vanderbilt University Medical Center, Nashville, TN.

Urology
|November 8, 2019
PubMed

Insights

Patients with a history of kidney stones face worse cardiac outcomes after percutaneous coronary intervention (PCI). Enhanced secondary cardiac prevention is recommended for these individuals to improve post-PCI results.

Area of Science:

  • Cardiology
  • Nephrology
  • Public Health

Background:

  • Kidney stone formers have a higher risk of coronary artery disease.
  • The impact of kidney stone history on cardiac outcomes after percutaneous coronary intervention (PCI) is not well understood.

Purpose of the Study:

  • To investigate the association between a history of kidney stones and adverse cardiac outcomes following PCI.

Main Methods:

  • Retrospective analysis of adult patients undergoing first-time PCI from two large databases: Vanderbilt University Medical Center (VUMC) and the Taiwan National Health Insurance Research Database (NHIRD).
  • Propensity score matching was used to compare outcomes between patients with and without a history of kidney stones.
  • Outcomes assessed included 30-day in-hospital mortality, and 1-year and 3-year adverse cardiac events, primarily myocardial infarction.

Main Results:

  • In the VUMC cohort, kidney stone formers showed significantly higher risks of 30-day mortality and 1- and 3-year myocardial infarction compared to controls.
  • The NHIRD cohort also demonstrated an association between kidney stone history and increased risk of 1- and 3-year myocardial infarction.
  • Sensitivity analyses indicated a marginal association with 30-day mortality and a significant association with 3-year myocardial infarction for patients who underwent kidney stone surgery.

Conclusions:

  • A history of kidney stones is linked to poorer cardiac outcomes after PCI.
  • Patients with kidney stones undergoing PCI may require intensified secondary cardiac prevention strategies to mitigate adverse events.
Abstract

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