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Acute kidney injury and multivessel percutaneous coronary interventions in chronic renal disease: the AMICI study

Alessandro Sciahbasi1, Andrea Cuono2, Alberto Marrangoni3

  • 1Department of Interventional Cardiology, Sandro Pertini Hospital, Rome, Italy - asciahbasi@gmail.com.

Minerva Cardiology and Angiology
|November 4, 2020
PubMed

Insights

For patients with chronic kidney disease (CKD), undergoing single versus multivessel percutaneous coronary interventions (PCI) does not alter acute kidney injury (AKI) risk. However, performing multivessel PCI in staged procedures lowers AKI risk compared to a single session.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Patients with chronic kidney disease (CKD) frequently have multivessel coronary artery disease.
  • Percutaneous coronary interventions (PCI) in CKD patients carry a high risk of acute kidney injury (AKI).

Purpose of the Study:

  • To compare the risk of AKI in CKD patients undergoing single-vessel PCI versus multivessel PCI.
  • To evaluate the impact of PCI procedural strategy on AKI risk in CKD patients.

Main Methods:

  • Retrospective analysis of PCI procedures performed between January 2011 and December 2017.
  • Inclusion criteria: patients with baseline glomerular filtration rate <60 mL/min/1.73 m².
  • Comparison of AKI rates between single-vessel PCI and multivessel PCI (single-session vs. staged procedures).

Main Results:

  • A total of 848 PCI procedures in 848 CKD patients were analyzed.
  • Overall AKI rate was approximately 15%, with no significant difference between single-vessel (15.5%) and multivessel PCI (14.8%).
  • In the multivessel PCI group, AKI risk was significantly higher in the single-session subgroup (21.4%) compared to the staged procedures subgroup (11.2%).

Conclusions:

  • The number of treated vessels in PCI does not influence AKI risk in CKD patients.
  • Multivessel PCI should be performed in multiple staged procedures to minimize AKI risk.
  • Staged multivessel PCI is a safer strategy for CKD patients compared to single-session multivessel PCI.
Abstract

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