Impact of Renal Function on Long-Term Clinical Outcomes in Patients With Coronary Chronic Total Occlusions: Results From an Observational Single-Center Cohort Study During the Last 12 Years

被引:8
作者
Guo, Lei [1 ]
Ding, Huaiyu [1 ]
Lv, Haichen [1 ]
Zhang, Xiaoyan [2 ]
Zhong, Lei [1 ]
Wu, Jian [1 ]
Xu, Jiaying [1 ]
Zhou, Xuchen [1 ]
Huang, Rongchong [3 ]
机构
[1] Dalian Med Univ, Affiliated Hosp 1, Dept Cardiol, Dalian, Peoples R China
[2] Anhui Med Univ, Fuyang Hosp, Dept Radiol, Fuyang, Peoples R China
[3] Capital Med Univ, Affiliated Beijing Friendship Hosp, Dept Cardiol, Beijing, Peoples R China
关键词
chronic total occlusions; medical therapy; outcomes; percutaneous coronary intervention; renal function; CHRONIC KIDNEY-DISEASE; SUCCESSFUL RECANALIZATION; ELDERLY-PATIENTS; MEDICAL THERAPY; INTERVENTION; INSUFFICIENCY; ANGIOPLASTY; DYSFUNCTION; IMPROVEMENT;
D O I
10.3389/fcvm.2020.550428
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: The number of coronary chronic total occlusion (CTO) patients with renal insufficiency is huge, and limited data are available on the impact of renal insufficiency on long-term clinical outcomes in CTO patients. We aimed to investigate clinical outcomes of CTO percutaneous coronary intervention (PCI) vs. medical therapy (MT) in CTO patients according to baseline renal function. Methods: In the study population of 2,497, 1,220 patients underwent CTO PCI and 1,277 patients received MT. Patients were divided into four groups based on renal function: group 1 [estimated glomerular filtration rate (eGFR) >= 90 ml/min/1.73 m(2)], group 2 (60 <= eGFR <90 ml/min/1.73 m(2)), group 3 (30 <= eGFR <60 ml/min/1.73 m(2)), and group 4 (eGFR <30 ml/min/1.73 m(2)). Major adverse cardiac event (MACE) was the primary end point. Results: Median follow-up was 2.6 years. With the decline in renal function, MACE (p < 0.001) and cardiac death (p < 0.001) were increased. In group 1 and group 2, MACE occurred less frequently in patients with CTO PCI, as compared to patients in the MT group (15.6% vs. 22.8%, p < 0.001; 15.6% vs. 26.5%, p < 0.001; respectively). However, there was no significant difference in terms of MACE between CTO PCI and MT in group 3 (21.1% vs. 28.7%, p = 0.211) and group 4 (28.6% vs. 50.0%, p = 0.289). MACE was significantly reduced for patients who received successful CTO PCI compared to patients with MT (16.7% vs. 22.8%, p = 0.006; 16.3% vs. 26.5%, p = 0.003, respectively) in group 1 and group 2. eGFR < 30 ml/min/1.73 m(2), age, male gender, diabetes mellitus, heart failure, multivessel disease, and MT were identified as independent predictors for MACE in patients with CTOs. Conclusions: Renal impairment is associated with MACE in patients with CTOs. For treatment of CTO, compared with MT alone, CTO PCI may reduce the risk of MACE in patients without chronic kidney disease (CKD). However, reduced MACE from CTO PCI among patients with CKD was not observed. Similar beneficial effects were observed in patients without CKD who underwent successful CTO procedures.
引用
收藏
页数:9
相关论文
共 50 条
[41]   Long-Term Clinical Outcomes in Patients With Chronic Total Occlusion of Single Coronary Artery Treated With Percutaneous Coronary Intervention versus Optimal Medical Therapy: A Ten-Year Follow Up Study [J].
Kim, Sungeun ;
Park, Taek Kyu ;
Choi, Seung-Hyuk .
CIRCULATION, 2022, 146
[42]   Evaluating the Impact of Eosinophil Count on the Long-term Clinical Outcomes of Patients With an Acute ST-segment Elevation Myocardial Infarction Who Require Emergency Percutaneous Coronary Intervention: Results of a Multicenter Cohort Study [J].
Guo, Lei ;
Liu, Hao ;
Dong, Zhichao ;
Zhou, Xuchen ;
Zhu, Hao ;
Gu, Xia ;
Zhang, Bo .
CARDIOLOGY DISCOVERY, 2024, 4 (04) :274-279
[43]   Impact of chronic kidney disease on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A long-term single-center mortality study [J].
Peyracchia, Mattia ;
Scacciatella, Paolo ;
Conrotto, Federico ;
Meynet, Ilaria ;
Biava, Lorenza M. ;
Budano, Carlo ;
Pennone, Mauro ;
D'Amico, Maurizio ;
Gaita, Fiorenzo .
MINERVA CARDIOANGIOLOGICA, 2018, 66 (01) :6-15
[44]   Long-Term Impact of Right Ventricular Pacing on Left Ventricular Systolic Function in Pacemaker Recipients With Preserved Ejection Fraction: Results From a Large Single-Center Registry [J].
Ebert, Micaela ;
Jander, Nikolaus ;
Minners, Jan ;
Blum, Thomas ;
Doering, Michael ;
Bollmann, Andreas ;
Hindrickks, Gerhard ;
Arentz, Thomas ;
Kalusche, Dietrich ;
Richter, Sergio .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2016, 5 (07)
[45]   Prognostic impact of recanalizing chronic total occlusion in non-infarct related arteries on long-term clinical outcomes in acute myocardial infarction patients undergoing primary percutaneous coronary intervention [J].
Yoshida, Ruka ;
Ishii, Hideki ;
Morishima, Itsuro ;
Tanaka, Akihito ;
Takagi, Kensuke ;
Yoshioka, Naoki ;
Kataoka, Takashi ;
Tashiro, Hiroshi ;
Hitora, Yusuke ;
Niwa, Kiyoshi ;
Furusawa, Kenji ;
Morita, Yasuhiro ;
Tsuboi, Hideyuki ;
Murohara, Toyoaki .
CARDIOVASCULAR INTERVENTION AND THERAPEUTICS, 2020, 35 (03) :259-268
[46]   Prognostic impact of recanalizing chronic total occlusion in non-infarct related arteries on long-term clinical outcomes in acute myocardial infarction patients undergoing primary percutaneous coronary intervention [J].
Ruka Yoshida ;
Hideki Ishii ;
Itsuro Morishima ;
Akihito Tanaka ;
Kensuke Takagi ;
Naoki Yoshioka ;
Takashi Kataoka ;
Hiroshi Tashiro ;
Yusuke Hitora ;
Kiyoshi Niwa ;
Kenji Furusawa ;
Yasuhiro Morita ;
Hideyuki Tsuboi ;
Toyoaki Murohara .
Cardiovascular Intervention and Therapeutics, 2020, 35 :259-268
[47]   Body Mass Index and Long-Term Follow-Up Outcomes in Patients With Acute Myocardial Infarction by the Median of Non-HDL Cholesterol: Results From an Observational Cohort Study in China [J].
Gao, Hui ;
Shen, Aidong ;
Chen, Hui ;
Li, Hongwei .
FRONTIERS IN CARDIOVASCULAR MEDICINE, 2021, 8
[48]   Long-term maintenance of hemoglobin levels in hemodialysis patients treated with bi-weekly epoetin beta pegol switched from darbepoetin alfa: a single-center, 12-month observational study in Japan [J].
Kawai, Toru ;
Kusano, Yoshie ;
Yamada, Kyouko ;
Ueda, Chikako ;
Kawai, Atsushi ;
Masaki, Takao .
JOURNAL OF ARTIFICIAL ORGANS, 2019, 22 (02) :146-153
[49]   Prognostic implications of mean platelet volume on short- and long-term outcomes among patients with non-ST-segment elevation myocardial infarction treated with percutaneous coronary intervention: A single-center large observational study [J].
Wasilewski, Jaroslaw ;
Desperak, Piotr ;
Hawranek, Michal ;
Cislak, Aneta ;
Osadnik, Tadeusz ;
Pyka, Lukasz ;
Gawlita, Marcin ;
Bujak, Kamil ;
Niedziela, Jacek ;
Krawczyk, Michal ;
Gasior, Mariusz .
PLATELETS, 2016, 27 (05) :452-458
[50]   The impact of dissection and re-entry versus wire escalation techniques on long-term clinical outcomes in patients with chronic total occlusion lesions following percutaneous coronary intervention: An updated meta-analysis [J].
Zhao, Yejing ;
Peng, Hongyu ;
Li, Xiaonan ;
Liu, Jinghua .
CARDIOLOGY JOURNAL, 2021, 28 (03) :369-383