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Title Impact of Chronic Kidney Disease on the Outcomes of Patients Undergoing Semi-Urgent and Elective Percutaneous Coronary Intervention |
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Type Free Paper Session 2 |
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Theme ACC Asia & SCS 32nd Annual Scientific Meeting |
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Topic Invasive Diagnostic & Interventional Cardiology |
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Main Author Pei Ying Ho1 |
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Presenting Author Pei Ying Ho1 |
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Co-Author Ching Hui Sia2 Rui Huai Lau1 Tiong Cheng Yeo1 2 Huay Cheem Tan1 2 Mark Yan Yee Chan1 2 Joshua Ping Yun Loh1 2 |
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Department / Institution / Country Yong Loo Lin School of Medicine / National University of Singapore / Singapore1 Department of Cardiology / National University Heart Centre / Singapore2 |
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Objective(s) Chronic kidney disease (CKD) is a significant predictor of mortality in patients with acute coronary syndromes. Percutaneous coronary intervention (PCI) for CKD patients remains challenging due to higher complication rates. The effects of CKD on mortality in patients undergoing semi-urgent and elective PCI is unclear. This study aims to investigate the impact of CKD on the outcomes of subjects in this population. |
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Material and Method This was a retrospective database study of patients who underwent semi-urgent and elective PCI from January 2014 to December 2015 at a tertiary academic centre. Patients were followed up until December 2018. The patients were stratified into 2 groups – Group 1 (eGFR< 60mls/min/1.73m2) and Group 2 (eGFR≥60mls/min/1.73m2). Demographics, risk factors and end-points (time-to-event analysis) including subsequent stroke/transient ischemic attack (TIA), myocardial infarction (MI), congestive cardiac failure (CCF) and all-cause mortality were analyzed. |
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Result(s) Of the 1,602 patients studied, 321 were in Group 1 (20.0%). Group 1 patients were predominantly male (67.9%) and Chinese (59.2%), with a mean age of 68.5 ± 10.9 years and a higher co-morbid burden of hypertension, dyslipidemia, diabetes and peripheral vascular disease. In terms of outcomes, Group 1 patients were twice as likely to develop subsequent stroke/TIA (6.2% vs 3.1%, p=0.009), MI (12.1% vs 5.0%, p<0.001) and thrice as likely to develop subsequent CCF (13.1% vs 4.4%). In Group 1 compared to Group 2 patients, all-cause mortality (29.6% vs 5.1%, p<0.001) and cardiac-related deaths (15.0% vs 1.8%, p<0.001) were almost 6-fold and 8-fold greater respectively. On multivariate Cox Regression analysis, subjects with progressively lower eGFR were associated with an increased risk of all-cause mortality while those already on dialysis did not have higher all-cause mortality. |
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Conclusion Patients with eGFR<60mls/min/1.73m2 who underwent semi-urgent and elective PCI had a higher co-morbidity burden and greater all-cause mortality as eGFR worsens. Further studies are required to examine this association. |