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Updated: Oct 21, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
How does clinical profile and outcome differ in patients with Chronic Kidney Disease undergoing percutaneous coronary
Meniya Jayesh1, Sharma Kamal1, Charaniya Riyaz1
1Department of Cardiology, U. N. Mehta Institute of Cardiology and Research Centre (UNMICRC), Civil Hospital Campus, Asarwa, Ahmedabad, 380016, Gujarat, India.
Insights
Chronic kidney disease (CKD) increases coronary artery disease risk. Lower estimated glomerular filtration rate (eGFR) below 36.25 mL/min/1.73 m² significantly predicts major adverse cardiac events after percutaneous coronary intervention (PCI).
Area of Science:
- Cardiology
- Nephrology
- Clinical Outcomes Research
Background:
- Chronic kidney disease (CKD) is a significant, independent risk factor for developing coronary artery disease (CAD).
- Patients with CKD undergoing percutaneous coronary intervention (PCI) face elevated risks for adverse cardiovascular events.
- Assessing CKD severity via estimated glomerular filtration rate (eGFR) is crucial for risk stratification in these patients.
Purpose of the Study:
- To evaluate the outcomes of patients with CKD undergoing PCI.
- To determine the impact of CKD severity, specifically eGFR levels, on major adverse cardiac events (MACE) post-PCI.
- To identify a predictive cut-off value for eGFR associated with adverse outcomes.
Main Methods:
- A prospective, observational study analyzed 100 CKD patients undergoing PCI with a 1-year follow-up.
- Receiver operator characteristics (ROC) analysis was employed to establish an eGFR cut-off value.
- Major adverse cardiac events (MACE) were defined as a composite of cardiovascular mortality, heart failure hospitalization, repeat revascularization, and non-fatal myocardial infarction.
Main Results:
- Patients were stratified into two groups based on an eGFR cut-off of 36.25 mL/min/1.73 m².
- An eGFR below 36.25 mL/min/1.73 m² was identified as the most robust predictor of MACE, conferring a 3-fold increased risk.
- Lower baseline left ventricular ejection fraction (LVEF) independently predicted heart failure hospitalization.
Conclusions:
- A baseline eGFR < 36.25 mL/min/1.73 m² is strongly associated with a higher incidence of MACE in CKD patients post-PCI.
- eGFR serves as a critical prognostic marker for cardiovascular outcomes in patients with CKD undergoing PCI.
- Lower baseline LVEF is an independent predictor of heart failure hospitalization in this patient cohort.
Background:
Chronic kidney disease (CKD) is an independent risk factor for the development of coronary artery disease. We evaluated outcomes amongst patients of CKD undergoing percutaneous coronary intervention (PCI) as assessed on severity of CKD based on estimated glomerular filtration rate (eGFR) at the time of PCI.
Method And Materials:
We analyzed 100 consecutive CKD patients who underwent PCI and were followed up for 1 year; an observational, prospective, open-label study. Multivariate and Receiver operator characteristics (ROC) analysis was used to determine the cut point ofeGFR for predicting 4-P major adverse cardiac events (MACE) outcomes defined as the composite of Cardiovascular (CV) mortality, heart failure hospitalization (HHF), repeat revascularization and non-fatal MI over 1 year follow up.
Results:
According to eGFR cut-off value derived from ROC, patients were divided in to two groups based on eGFR cut-off of 36.25 mL/min/1.73 m2. Majority of patients (79%) were in Group 1 (eGFR >36.25 mL/min/1.73 m2). Group 2 had Lower HbA1C, hemoglobin and elevated level of urea as compared to group:1 (p=0.002,<0.0001 respectively). All-cause mortality had trend forbeing higher (6.3 vs. 19%) in group:2, but statistically non-significant (p = 0.17). Lower baseline LVEF (39 ± 10.08%) across the cohort was independent predictor of higher risk for HHF. eGFR <36.25 mL/mim/1.73 m2 was the most robust predictor of MACE, carrying a 3-fold increase in risk of 4-P MACE with significant association (0.69, CI 0.59 to 0.78, p = 0.0009).
Conclusions:
Lower baseline eGFR was associated with higher incidence of 4 P MACE with best cut-off being eGFR <36.25 mL/min/1.73 m2. Lower Baseline LVEF was independent predictor from HHF across the cohort.
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