Mayo Clinic proceedings · 2025
Impact of Renal Function and Acute Kidney Injury on Long-term Outcomes After Percutaneous Coronary Intervention.
СтатьяНазвание и аннотация: Перевод в очереди
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Nagaraja Vinayak, Rihal Charanjit S, Reeder Guy, Nath Karl A, Lewis Bradley R, Singh Mandeep
Аннотация
OBJECTIVE: To determine the incidence, predictors, and prognostic implications of acute kidney injury (AKI) after percutaneous coronary intervention (PCI).
PATIENTS AND METHODS: Retrospective analysis of the Mayo Clinic PCI registry identified 9199 patients who underwent PCI from January 1, 2009, through June 30, 2023.
RESULTS: A total of 856 patients (9.3%) developed AKI (increase in serum creatinine level by ≥0.3 mg/dL or ≥1.5 times baseline), with 87 (0.9%) requiring hemodialysis. A monotonic increase in the yearly incidence of AKI was observed (P<.001). In multivariable analysis, AKI was associated with older age (odds ratio [OR], 1.01; 95% CI, 1.00 to 1.02), female sex (OR, 1.27; 95% CI, 1.08 to 1.49), diabetes (OR, 1.62; 95% CI, 1.38 to 1.89), congestive heart failure (OR, 2.99; 95% CI, 2.54 to 3.52), chronic kidney disease (OR, 2.46; 95% CI, 2.00 to 3.02), acute myocardial infarction (OR, 3.34; 95% CI, 2.80 to 3.99), intra-aortic balloon pump (OR, 3.49; 95% CI, 2.55 to 4.73), and contrast volume (OR, 1.28; 95% CI, 1.17 to 1.41). In-hospital mortality was 11.1% vs 1.0% in patients with vs without AKI (P<.001). After adjustment, AKI remained strongly associated with in-hospital mortality (hazard ratio, 5.75; 95% CI, 4.06 to 8.13). Among hospital survivors, 1-, 5-, and 10-year all-cause mortality, repeated revascularization, myocardial infarction, and major adverse cardiovascular event rates were significantly higher in those who developed AKI.
CONCLUSIONS: The incidence of AKI after PCI remains high in the contemporary era. Higher in-hospital and long-term mortality and adverse cardiac event rates were noted in patients who developed AKI after PCI.
PATIENTS AND METHODS: Retrospective analysis of the Mayo Clinic PCI registry identified 9199 patients who underwent PCI from January 1, 2009, through June 30, 2023.
RESULTS: A total of 856 patients (9.3%) developed AKI (increase in serum creatinine level by ≥0.3 mg/dL or ≥1.5 times baseline), with 87 (0.9%) requiring hemodialysis. A monotonic increase in the yearly incidence of AKI was observed (P<.001). In multivariable analysis, AKI was associated with older age (odds ratio [OR], 1.01; 95% CI, 1.00 to 1.02), female sex (OR, 1.27; 95% CI, 1.08 to 1.49), diabetes (OR, 1.62; 95% CI, 1.38 to 1.89), congestive heart failure (OR, 2.99; 95% CI, 2.54 to 3.52), chronic kidney disease (OR, 2.46; 95% CI, 2.00 to 3.02), acute myocardial infarction (OR, 3.34; 95% CI, 2.80 to 3.99), intra-aortic balloon pump (OR, 3.49; 95% CI, 2.55 to 4.73), and contrast volume (OR, 1.28; 95% CI, 1.17 to 1.41). In-hospital mortality was 11.1% vs 1.0% in patients with vs without AKI (P<.001). After adjustment, AKI remained strongly associated with in-hospital mortality (hazard ratio, 5.75; 95% CI, 4.06 to 8.13). Among hospital survivors, 1-, 5-, and 10-year all-cause mortality, repeated revascularization, myocardial infarction, and major adverse cardiovascular event rates were significantly higher in those who developed AKI.
CONCLUSIONS: The incidence of AKI after PCI remains high in the contemporary era. Higher in-hospital and long-term mortality and adverse cardiac event rates were noted in patients who developed AKI after PCI.