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Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention

Wenguang Lai1,2,3, Xiaoli Zhao4, Sijia Yu2,3,5

  • 1School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China.

Frontiers in Cardiovascular Medicine
|April 18, 2022
PubMed

Insights

Chronic kidney disease (CKD) significantly increases the risk of developing heart failure with reduced ejection fraction (HFrEF) after percutaneous coronary intervention (PCI). This association highlights the need for proactive management in CKD patients undergoing PCI to prevent HFrEF and reduce mortality.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Research

Background:

  • Chronic kidney disease (CKD) is prevalent in patients at high risk for heart failure with reduced ejection fraction (HFrEF).
  • The impact of CKD on incident HFrEF in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains understudied.

Purpose of the Study:

  • To investigate the association between chronic kidney disease (CKD) and the incidence of heart failure with reduced ejection fraction (HFrEF).
  • To examine the impact of CKD on all-cause mortality in patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).

Main Methods:

  • A cohort of 2,356 patients with baseline left ventricular ejection fraction (LVEF) ≥ 40% undergoing PCI between January 2007 and December 2018 was analyzed.
  • Incident HFrEF was defined as a follow-up LVEF < 40% within 3-12 months post-discharge.
  • Multivariable logistic regression was employed to assess the relationship between CKD and incident HFrEF, adjusting for multiple confounders.

Main Results:

  • Of the 2,356 patients, 18.5% had CKD, and 3.5% developed incident HFrEF.
  • The incidence of HFrEF was significantly higher in the CKD group (6.9%) compared to the non-CKD group (2.8%; p < 0.001).
  • CKD was identified as an independent risk factor for incident HFrEF (aOR = 1.75; p = 0.035), and patients with incident HFrEF had higher all-cause mortality (26.5% vs. 8.1%; p < 0.001).

Conclusions:

  • CKD is independently associated with an increased risk of developing HFrEF following PCI in patients with CAD.
  • The presence of CKD in patients undergoing PCI is linked to higher all-cause mortality.
  • Implementing more aggressive preventive strategies for HFrEF is crucial for patients with CKD undergoing PCI.
Abstract

Keywords:
chronic kidney diseasecoronary artery diseaseheart failure with reduced ejection fractionincidenceleft ventricular ejection fractionpercutaneous coronary intervention

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