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Updated: Jan 11, 2026

A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion
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A Large Animal Model for Acute Kidney Injury by Temporary Bilateral Renal Artery Occlusion

Published on: February 2, 2021

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Left main percutaneous or surgical revascularisation and subsequent risk of transient and persistent renal

Laura Novelli1,2, Jorge Sanz-Sanchez3,4, Alessandra Iaccarino5

  • 1Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.

Open Heart
|November 10, 2025
PubMed

Insights

Acute kidney injury (AKI) is common after left main coronary artery disease (LMCAD) revascularization, occurring more after coronary artery bypass graft (CABG) than percutaneous coronary intervention (PCI). Only persistent renal dysfunction (RD) after AKI significantly impacts long-term prognosis.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Acute kidney injury (AKI) is a known complication of percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG).
  • Limited data exists on AKI incidence and prognosis after revascularization for left main coronary artery disease (LMCAD), particularly concerning persistent renal dysfunction (RD).

Purpose of the Study:

  • To investigate the incidence and prognostic impact of AKI following LMCAD revascularization.
  • To compare AKI rates between PCI and CABG for LMCAD.
  • To assess the risk of persistent RD and its association with mortality after LMCAD revascularization.

Main Methods:

  • Retrospective analysis of consecutive patients undergoing PCI or CABG for LMCAD (2015-2022).
  • AKI defined as serum creatinine increase ≥0.3 mg/dL or >50% from baseline.
  • Persistent RD defined as sustained sCr increase at 1 year.
  • Multivariable logistic regression and IPTW used to compare AKI risk between PCI and CABG.
  • Cox regression analyzed the prognostic impact of transient and persistent RD.

Main Results:

  • 1047 patients included (PCI: 617, CABG: 430).
  • AKI incidence was 17% after PCI vs. 28% after CABG (adjusted OR 2.82).
  • AKI increased 1-year all-cause mortality risk.
  • Persistent RD, not transient AKI, significantly worsened prognosis (HR 9.56).

Conclusions:

  • AKI is frequent after LMCAD revascularization, with higher rates after CABG compared to PCI.
  • AKI significantly impacts prognosis, but primarily when it leads to persistent renal dysfunction.
  • The development of persistent RD is a critical factor in long-term outcomes following LMCAD revascularization.
Abstract

Keywords:
Coronary Artery BypassCoronary StenosisPercutaneous Coronary Intervention

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