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Prognostic Impact of Renal Dysfunction at 1-Year Follow-Up on Clinical Outcomes After Percutaneous Coronary

Tetsuya Takahashi1, Tetsu Watanabe2, Tomonori Aono2

  • 1The Department of Cardiology, Japanese Red Cross Ishinomaki Hospital.

Journal of Atherosclerosis and Thrombosis
|September 19, 2022
PubMed

Insights

Persistent or new renal dysfunction after percutaneous coronary intervention (PCI) in coronary artery disease (CAD) patients predicts worse long-term outcomes. Monitoring renal function post-PCI is crucial for managing CAD patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Outcomes Research

Background:

  • Renal dysfunction is a known risk factor for adverse events in coronary artery disease (CAD).
  • The impact of changes in renal function over the mid-term following percutaneous coronary intervention (PCI) on long-term outcomes is not well-established.

Purpose of the Study:

  • To evaluate the association between mid-term changes in renal dysfunction status and long-term clinical outcomes in CAD patients who have undergone PCI.
  • To identify the prognostic significance of persistent and new-onset renal dysfunction after PCI.

Main Methods:

  • A cohort of 382 consecutive CAD patients undergoing PCI was analyzed.
  • Renal dysfunction was defined as an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m².
  • Renal function was assessed at baseline and 1-year post-PCI, categorizing patients into persistent dysfunction, new-onset dysfunction, or improved/no dysfunction groups.

Main Results:

  • At baseline, 20% of patients had renal dysfunction.
  • At 1-year follow-up, 12% developed new-onset renal dysfunction and 15% had persistent renal dysfunction.
  • Both persistent and new-onset renal dysfunction were significantly associated with higher rates of composite events (all-cause death, acute coronary syndrome, target vessel revascularization, stroke) (P=0.0003).
  • Multivariate analysis confirmed persistent (aHR 4.08) and new-onset (aHR 2.64) renal dysfunction as independent predictors of adverse outcomes.

Conclusions:

  • Persistent renal dysfunction at 1-year post-PCI is linked to unfavorable long-term outcomes in CAD patients.
  • New-onset renal dysfunction developing within 1 year after PCI also indicates a poorer prognosis.
  • These findings highlight the importance of monitoring renal function changes in CAD patients treated with PCI.
Abstract

Keywords:
Clinical outcomePercutaneous coronary interventionRenal dysfunction

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