TY - JOUR
T1 - Association of chronic renal insufficiency with in-hospital outcomes after percutaneous coronary intervention
AU - Gupta, Tanush
AU - Paul, Neha
AU - Kolte, Dhaval
AU - Harikrishnan, Prakash
AU - Khera, Sahil
AU - Aronow, Wilbert S.
AU - Mujib, Marjan
AU - Palaniswamy, Chandrasekar
AU - Sule, Sachin
AU - Jain, Diwakar
AU - Ahmed, Ali
AU - Cooper, Howard A.
AU - Frishman, William H.
AU - Bhatt, Deepak L.
AU - Fonarow, Gregg C.
AU - Panza, Julio A.
N1 - Publisher Copyright:
© 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
PY - 2015/6/16
Y1 - 2015/6/16
N2 - 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.
AB - 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.
KW - chronic kidney disease
KW - end‐stage renal disease
KW - in‐hospital mortality
KW - percutaneous coronary intervention
KW - postprocedure hemorrhage
UR - http://www.scopus.com/inward/record.url?scp=85018196896&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018196896&partnerID=8YFLogxK
U2 - 10.1161/JAHA.115.002069
DO - 10.1161/JAHA.115.002069
M3 - Article
C2 - 26080814
AN - SCOPUS:85018196896
SN - 2047-9980
VL - 4
SP - e002069
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 6
ER -