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Impact of impaired renal function on outcomes of chronic total occlusion undergoing revascularization: a systemic

Yonghui Qi1, Jiqing He1, Mingjiao Pan1

  • 1Blood Purification Center of Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, No.19 Xiuhua Road, Xiuying District, Haikon City, Hianan Province, China.

International Urology and Nephrology
|June 11, 2022
PubMed

Insights

Chronic kidney disease (CKD) significantly increases risks for patients undergoing coronary chronic total occlusion (CTO) revascularization, including higher mortality and complications. Comprehensive kidney function evaluation and close monitoring are crucial for these high-risk patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Coronary artery disease (CAD) is common in patients with chronic kidney disease (CKD).
  • Chronic total occlusions (CTOs) represent a significant challenge in CAD management.
  • The impact of CKD on CTO revascularization outcomes remains incompletely understood.

Purpose of the Study:

  • To systematically review and analyze the outcomes of CTO revascularization in patients with and without CKD.
  • To quantify the association between CKD and adverse events following CTO revascularization.

Main Methods:

  • A systematic literature search was performed across PubMed, Scopus, and Google Scholar.
  • Included studies compared outcomes of CTO revascularization in patients with and without CKD.
  • Pooled relative risk (RR) was calculated using STATA software.

Main Results:

  • CKD patients faced higher in-hospital mortality (RR 4.25) and long-term mortality (RR 3.24).
  • Increased risks observed for major adverse cardiovascular/cerebrovascular events (RR 1.65), major bleeding (RR 2.85), and contrast-induced acute kidney injury (RR 3.06).
  • Lower technical success rates were noted in CKD patients (RR 0.95).

Conclusions:

  • CKD presence is associated with increased mortality and complications after CTO revascularization.
  • CKD adversely impacts the technical success of CTO revascularization procedures.
  • Thorough kidney function assessment and vigilant monitoring are essential for CKD patients undergoing CTO revascularization.
Abstract

Keywords:
CTO revascularizationChronic kidney diseaseChronic total occlusionCoronary artery diseaseMeta-analysis

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