Adverse impact of chronic kidney disease on clinical outcomes following percutaneous coronary intervention
Jason Bloom, Diem Dinh, Samer Noaman, Catherine Martin, Michael Lim, R. Batchelor, W. Zheng, Christopher M. Reid, Angela Brennan, Jeffrey Lefkovits, Nicholas Cox, Stephen J. Duffy, William Chan
Abstract
Abstract Aims We aimed to assess the impact of the severity of chronic kidney disease (CKD) with long‐term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). Methods We analyzed data on consecutive patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR) from January 2014 to December 2018. Patients were stratified into tertiles of renal function; estimated glomerular filtration (eGFR) ≥60, 30–59 and < 30 ml/min/1.73 m 2 (including dialysis). The primary outcome was long‐term all‐cause mortality obtained from linkage with the Australian National Death Index (NDI). The secondary endpoint was a composite of 30 day major adverse cardiac and cerebrovascular events. Results We identified a total of 51,480 patients (eGFR ≥60, n = 40,534; eGFR 30–59, n = 9,521; eGFR <30, n = 1,425). Compared with patients whose eGFR was ≥60, those with eGFR 30–59 and eGFR<30 were on average older (77 and 78 vs. 63 years) and had a greater burden of cardiovascular risk factors. Worsening CKD severity was independently associated with greater adjusted risk of long‐term NDI mortality: eGFR<30 hazard ratio 4.21 (CI 3.7–4.8) and eGFR 30–59; 1.8 (CI 1.7–2.0), when compared to eGFR ≥60, all p < .001. Conclusion In this large, multicentre PCI registry, severity of CKD was associated with increased risk of all‐cause mortality underscoring the high‐risk nature of this patient cohort.