Related Experiment Video
Updated: Sep 17, 2025
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Impact of left ventricular function on outcomes in patients with chronic kidney disease undergoing percutaneous
Nicholas Pitaro1, Johny Nicolas1, Samantha Sartori1
1Icahn School of Medicine at Mount Sinai, Mount Sinai Fuster Heart Hospital, New York, NY.
Insights
Reduced left ventricular ejection fraction (LVEF) increases risks for patients undergoing percutaneous coronary intervention (PCI). This includes higher risks of death and myocardial infarction, regardless of chronic kidney disease (CKD) status.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Reduced left ventricular ejection fraction (LVEF) is a known risk factor for adverse outcomes post-percutaneous coronary intervention (PCI).
- The prognostic impact of reduced LVEF in patients with chronic kidney disease (CKD) undergoing PCI is not well-established.
- CKD is increasingly prevalent and associated with cardiovascular complications.
Purpose of the Study:
- To investigate the impact of reduced LVEF on major adverse cardiovascular events (MACE) in patients with and without CKD undergoing PCI.
- To stratify risks associated with reduced LVEF in the context of CKD and PCI.
- To determine if CKD modifies the effect of reduced LVEF on PCI outcomes.
Main Methods:
- A retrospective analysis of 12,353 patients who underwent PCI between 2012 and 2023.
- Patients were categorized based on the presence of CKD (eGFR <60 mL/min/1.73 m²) and reduced LVEF (<50%).
- The primary endpoint was MACE (all-cause death, MI, or target vessel revascularization) at 1 year post-PCI.
Main Results:
- Among 3,199 CKD patients, 23.5% had reduced LVEF. Reduced LVEF was associated with higher prevalence of advanced atherosclerosis and comorbidities.
- No significant difference in MACE was observed between CKD patients with reduced versus normal LVEF (HR 1.18, P = .23).
- However, reduced LVEF in CKD patients was linked to significantly higher risks of all-cause death (HR 1.85, P < .05) and MI (HR 1.78, P < .05). Non-CKD patients also showed increased risks.
Conclusions:
- Reduced LVEF is associated with increased risks of death and myocardial infarction after PCI, irrespective of CKD status.
- The findings suggest that reduced LVEF is an independent risk factor for adverse cardiovascular events in patients undergoing PCI.
- Close monitoring and risk stratification are warranted for patients with reduced LVEF, especially those with CKD, undergoing PCI.
Background:
Reduced left ventricular ejection fraction (LVEF) is associated with increased morbidity and mortality after percutaneous coronary intervention (PCI). The impact of reduced LVEF among patients with chronic kidney disease (CKD) undergoing PCI remains unclear.
Methods:
We included all patients who underwent PCI at a tertiary-care center, between 2012 and 2023. Patients were divided into those with and without CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) and further stratified by the presence of reduced LVEF (<50%). The primary endpoint was major adverse cardiovascular events (MACE), a composite of all-cause death, myocardial infarction (MI), or target vessel revascularization at 1 year after PCI.
Results:
Out of 12,353 patients, 3,199 (25.9%) had CKD of whom 751 (23.5%) had reduced LVEF. In patients with CKD, mean LVEF was 36.7 ± 8.5% and 59.6 ± 4.9% in those with reduced and normal LVEF, respectively (P < .001). Those with reduced vs normal LVEF had a higher prevalence of advanced atherosclerotic disease and comorbidities. There was no significant difference in MACE among CKD patients with reduced vs normal LVEF (HR 1.18, 95% CI 0.90-1.54, P = .23). Nonetheless, those with reduced vs normal LVEF had higher risk of all-cause death (HR 1.85, 95% CI 1.10-3.10, P < .05) and MI (HR 1.78, 95% CI 1.07-2.98, P < .05). Concordantly, non-CKD patients had increased risk of MACE and all-cause death; no significant interaction was found between LVEF and presence of CKD.
Conclusions:
Reduced LVEF may adversely affect outcomes in patients with and without CKD alike.
More Related Videos
14:35Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
08:49Author Spotlight: Enhancing Graft Viability Assessment Through Quantitative Metrics and Innovative Reservoir Systems
Published on: August 2, 2024
Related Concept Videos
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:28Chronic Kidney Disease III: Interprofessional Care
01:18Chronic Kidney Disease IV: Nursing Management
01:22Heart Failure Drugs: Diuretics
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
01:20Acute Kidney Injury V: Interprofessional Care