Higher inpatient mortality following percutaneous coronary intervention in patients with advanced chronic kidney disease.

IF 1.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Coronary artery disease Pub Date : 2024-12-01 Epub Date: 2024-06-19 DOI:10.1097/MCA.0000000000001379

Mohammad Reza Movahed, Sina Aghdasi, Madhan Shanmugasundaram, Mehrtash Hashemzadeh

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引用次数: 0

Abstract

Background: Advanced chronic kidney disease (ACKD) is common in patients undergoing percutaneous coronary intervention (PCI) and is associated with adverse outcomes. These patients are often excluded from revascularization studies. The goal of this study was to evaluate the impact of ACKD in patients undergoing PCI.

Methods: We analyzed the national inpatient sample database to compare the inpatient mortality rate for ACKD patients [chronic kidney disease (CKD) stage 3 and above] who underwent PCI between 2006 and 2011 to patients without ACKD. Specific ICD-9 CM codes were used to identify these patients.

Results: A total of 1 826 536 PCIs were performed during the study period, of which 113 018 (6.2%) were patients with advanced CKD. The age-adjusted inpatient mortality rates were significantly higher in the ACKD group in all years studied compared to the no CKD group. For the first year studied in 2006, the age-adjusted mortality rate for patients undergoing PCI was 149 per 100 000 vs. 48 per 100 000 in patients without ACKD ( P < 0001). In the last year studied in 2011, age-adjusted mortality was 124.1 per 100 000 vs. 40.4 per 100 000 in patients with no ACKD, ( P < 0.0001). The presence of ACKD remained independently associated with higher mortality despite multivariate adjustment (odds ratio: 1.32, confidence interval: 1.27-1.36, P < 0.001).

Conclusion: ACKD is independently associated with higher mortality in patients undergoing PCI. Therefore, PCI in these patients should be performed with more caution.

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晚期慢性肾病患者经皮冠状动脉介入治疗后的住院死亡率较高。

背景：晚期慢性肾病（ACKD）在接受经皮冠状动脉介入治疗（PCI）的患者中很常见，并与不良预后有关。这些患者通常被排除在血管重建研究之外。本研究旨在评估 ACKD 对接受 PCI 患者的影响：我们分析了全国住院患者样本数据库，比较了 2006 年至 2011 年期间接受 PCI 治疗的 ACKD 患者（慢性肾脏病 (CKD) 3 期及以上）与无 ACKD 患者的住院死亡率。研究使用特定的 ICD-9 CM 代码来识别这些患者：研究期间共进行了1 826 536例PCI，其中113 018例（6.2%）为晚期CKD患者。与无 CKD 组相比，在所有研究年份中，ACKD 组的年龄调整后住院患者死亡率都明显较高。在研究的第一年，即 2006 年，接受 PCI 治疗的患者经年龄调整后的死亡率为每 10 万人中有 149 人死亡，而无 ACKD 患者的死亡率为每 10 万人中有 48 人死亡：ACKD 与接受 PCI 治疗的患者死亡率较高密切相关。因此，对这些患者进行 PCI 时应更加谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.