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Higher inpatient mortality following percutaneous coronary intervention in patients with advanced chronic kidney

Mohammad Reza Movahed1,2, Sina Aghdasi1, Madhan Shanmugasundaram1

  • 1College of Medicine, University of Arizona Sarver Heart Center, Tucson.

Coronary Artery Disease
|June 20, 2024
PubMed

Insights

Patients with advanced chronic kidney disease (ACKD) undergoing percutaneous coronary intervention (PCI) face higher inpatient mortality. These findings highlight the need for increased caution during PCI procedures for ACKD patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Health Outcomes Research

Background:

  • Advanced chronic kidney disease (ACKD) is prevalent in patients undergoing percutaneous coronary intervention (PCI).
  • ACKD is linked to adverse outcomes, yet these patients are often excluded from revascularization studies.
  • Understanding the impact of ACKD on PCI outcomes is crucial for patient care.

Purpose of the Study:

  • To evaluate the impact of advanced chronic kidney disease (ACKD) on patients undergoing percutaneous coronary intervention (PCI).
  • To compare inpatient mortality rates between ACKD and non-ACKD patients undergoing PCI.

Main Methods:

  • Analysis of the national inpatient sample database from 2006 to 2011.
  • Identification of ACKD patients (CKD stage 3 and above) and non-ACKD patients who underwent PCI using ICD-9 CM codes.
  • Comparison of age-adjusted inpatient mortality rates between the two groups.

Main Results:

  • Over 1.8 million PCIs were performed, with 6.2% in ACKD patients.
  • ACKD patients exhibited significantly higher age-adjusted inpatient mortality rates across all study years (e.g., 149/100,000 in 2006 vs. 48/100,000).
  • ACKD independently predicted higher mortality (OR: 1.32, CI: 1.27-1.36, P < 0.001) after multivariate adjustment.

Conclusions:

  • Advanced chronic kidney disease is an independent predictor of increased inpatient mortality in patients undergoing PCI.
  • PCI procedures in patients with ACKD warrant heightened vigilance and careful management.
Abstract

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