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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

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Impact of complex percutaneous coronary intervention features on clinical outcomes in patients with or without

Huazhen Chen1, Alessandro Spirito1, Samantha Sartori1

  • 1The Zena and Michael A. Wiener Cardiovascular institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|January 24, 2023
PubMed

Insights

Complex percutaneous coronary intervention (CPCI) increases risks for major adverse cardiac events and bleeding in patients with and without chronic kidney disease (CKD). CPCI specifically predicted mortality in CKD patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Patients with chronic kidney disease (CKD) face elevated risks of ischemic and bleeding complications post-percutaneous coronary intervention (PCI).
  • Complex PCI (CPCI) is known to increase ischemic complication rates.
  • The combined impact of CPCI and CKD on adverse events remains unclear.

Purpose of the Study:

  • To investigate whether complex PCI (CPCI) confers an additional risk of adverse cardiovascular events in patients with chronic kidney disease (CKD).
  • To compare the outcomes of CPCI versus standard PCI in patients stratified by CKD status.

Main Methods:

  • A retrospective analysis of 15,071 patients undergoing PCI between 2012 and 2019.
  • Patients were categorized based on CKD status and whether they underwent CPCI.
  • Primary outcome was major adverse cardiac events (MACE) at 1-year, including all-cause death, myocardial infarction (MI), and target-vessel revascularization (TVR). Major bleeding was a secondary outcome.

Main Results:

  • Complex PCI (CPCI) was associated with a significantly higher risk of MACE in both CKD and non-CKD patients.
  • CPCI increased the risk of death, MI, and TVR in CKD patients, and MI and TVR in non-CKD patients.
  • Major bleeding risk also increased with CPCI in both CKD and non-CKD groups, though the association was stronger in CKD patients.

Conclusions:

  • Complex PCI (CPCI) is linked to increased risks of MACE and major bleeding, regardless of chronic kidney disease (CKD) status.
  • CPCI specifically emerged as a predictor of mortality solely in patients with CKD.
Abstract

Keywords:
chronic kidney diseasecomplex PCIcoronary artery diseaseoutcomespercutaneous coronary intervention

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