Association of Chronic Renal Insufficiency With In-Hospital Outcomes After Percutaneous Coronary Intervention

被引：55

作者：

Gupta, Tanush ^{[1
]}

Paul, Neha ^{[1
]}

Kolte, Dhaval ^{[1
]}

Harikrishnan, Prakash ^{[1
]}

Khera, Sahil ^{[2
]}

Aronow, Wilbert S. ^{[2
]}

Mujib, Marjan ^{[1
]}

Palaniswamy, Chandrasekar ^{[3
]}

Sule, Sachin ^{[1
]}

Jain, Diwakar ^{[2
]}

Ahmed, Ali ^{[4
]}

Cooper, Howard A. ^{[2
]}

Frishman, William H. ^{[2
]}

Bhatt, Deepak L. ^{[5
]}

Fonarow, Gregg C. ^{[6
]}

Panza, Julio A. ^{[2
]}

机构：

[1] New York Med Coll, Dept Med, Valhalla, NY 10595 USA

[2] New York Med Coll, Div Cardiol, Valhalla, NY 10595 USA

[3] Mt Sinai Med Ctr, Div Cardiol, New York, NY 10029 USA

[4] Vet Affairs Med Ctr, Washington, DC 20422 USA

[5] Harvard Univ, Sch Med, Brigham & Womens Hosp, Heart & Vasc Ctr, Boston, MA 02115 USA

[6] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2015年 / 4卷 / 06期

关键词：

chronic kidney disease; end-stage renal disease; in-hospital mortality; percutaneous coronary intervention; postprocedure hemorrhage; CHRONIC KIDNEY-DISEASE; GLYCOPROTEIN IIB/IIIA INHIBITORS; ACUTE MYOCARDIAL-INFARCTION; METAL STENT IMPLANTATION; SUDDEN CARDIAC DEATH; DRUG-ELUTING STENT; HIGH-RISK PATIENTS; ADMINISTRATIVE DATA; CLINICAL-OUTCOMES; CARDIOVASCULAR-DISEASE;

D O I：

10.1161/JAHA.115.002069

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background-The association of chronic renal insufficiency with outcomes after percutaneous coronary intervention (PCI) in the current era of drug-eluting stents and modern antithrombotic therapy has not been well characterized. Methods and Results-We queried the 2007-2011 Nationwide Inpatient Sample databases to identify all patients aged >= 18 years who underwent PCI. Multivariable logistic regression was used to compare in-hospital outcomes among patients with chronic kidney disease (CKD), patients with end-stage renal disease (ESRD), and those without CKD or ESRD. Of 3 187 404 patients who underwent PCI, 89% had no CKD/ESRD; 8.6% had CKD; and 2.4% had ESRD. Compared to patients with no CKD/ESRD, patients with CKD and patients with ESRD had higher in-hospital mortality (1.4% versus 2.7% versus 4.4%, respectively; adjusted odds ratio for CKD 1.15, 95% CI 1.12 to 1.19, P<0.001; adjusted odds ratio for ESRD 2.29, 95% CI 2.19 to 2.40, P<0.001), higher incidence of postprocedure hemorrhage (3.5% versus 5.4% versus 6.0%, respectively; adjusted odds ratio for CKD 1.21, 95% CI 1.18 to 1.23, P<0.001; adjusted odds ratio for ESRD 1.27, 95% CI 1.23 to 1.32, P<0.001), longer average length of stay (2.9 days versus 5.0 days versus 6.4 days, respectively; P<0.001), and higher average total hospital charges ($60 526 versus $77 324 versus $97 102, respectively; P<0.001). Similar results were seen in subgroups of patients undergoing PCI for acute coronary syndrome or stable ischemic heart disease. Conclusions-In patients undergoing PCI, chronic renal insufficiency is associated with higher in-hospital mortality, higher postprocedure hemorrhage, longer average length of stay, and higher average hospital charges.

引用

页数：12

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