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Prognostic Impact of Chronic Kidney Disease After Percutaneous Coronary Intervention with Drug-Coated Balloons
Tetsuya Takahashi1, Tetsu Watanabe2, Mashu Toyoshima1
1The Department of Cardiology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki 986-0861, Japan.
Insights
Chronic kidney disease (CKD) significantly increases adverse outcomes, including death, in patients with coronary artery disease (CAD) undergoing drug-coated balloon (DCB) percutaneous coronary intervention (PCI). This highlights CKD as a critical prognostic factor in this patient group.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Drug-coated balloons (DCB) represent an advancing technology for percutaneous coronary intervention (PCI).
- Prognostic factors for PCI using DCB require further elucidation.
- Chronic kidney disease (CKD) is a known independent predictor of adverse events in coronary artery disease (CAD) patients post-PCI.
Purpose of the Study:
- To investigate the impact of CKD on the prognosis of CAD patients undergoing PCI with DCB.
Main Methods:
- A cohort of 252 consecutive CAD patients treated with DCB-PCI between 2015 and 2023 was analyzed.
- Composite endpoints included all-cause death, myocardial infarction, target vessel revascularization, stroke, and major bleeding.
- Statistical analyses included Kaplan-Meier and multivariate Cox proportional hazards models.
Main Results:
- The prevalence of CKD in the study population was 48%.
- Patients with CKD were older and had a higher incidence of hypertension and diabetes mellitus.
- CKD was significantly associated with a higher rate of composite events (log-rank test, p = 0.003) and independently predicted adverse outcomes (aHR 1.985, p = 0.013), primarily driven by all-cause mortality.
Conclusions:
- CKD is linked to poorer outcomes in CAD patients undergoing DCB-PCI.
- CKD independently predicts adverse composite events, particularly mortality, in this population.
- These findings underscore the importance of considering CKD status in risk stratification and management strategies for DCB-PCI.
Abstract:
Background: A drug-coated balloon (DCB) is an emerging treatment technology for percutaneous coronary intervention (PCI). However, the prognostic factors of PCI with a DCB remain fully determined. Chronic kidney disease (CKD) is an independent predictor of adverse outcomes in patients with coronary artery disease (CAD) who underwent PCI. The aim of this present study was to clarify the impact of CKD on prognosis in CAD patients who underwent PCI with a DCB. Methods: We enrolled 252 consecutive patients with CAD who underwent PCI with a DCB from 2015 to 2023. The endpoints of this study were composite events including all-cause death, myocardial infarction, target vessel revascularization, stroke, and major bleeding. Results: The prevalence rate of CKD was 48%. Patients with CKD were older and had higher prevalence of hypertension and diabetes mellitus than those without. Kaplan-Meier analysis revealed a significantly higher composite event rate in patients with CKD (log-rank test, p = 0.003). In the multivariate Cox proportional hazards analysis, CKD was independently associated with composite events after adjusting for confounding factors (adjusted hazard ratio 1.985, 95% confidence intervals 1.157-3.406, p = 0.013), mainly driven by all-cause deaths. Conclusions: CKD was associated with unfavorable outcomes in CAD patients who underwent PCI with a DCB.
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