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2016 ; 6
(3
): 169-79
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Determinants of Mortality in Patients with Chronic Kidney Disease Undergoing
Percutaneous Coronary Intervention
#MMPMID27275153
Papachristidis A
; Lim WY
; Voukalis C
; Ayis S
; Laing C
; Rakhit RD
Cardiorenal Med
2016[May]; 6
(3
): 169-79
PMID27275153
show ga
BACKGROUND: Renal impairment is a known predictor of mortality in both the
general population and in patients with cardiac disease. The aim of this study
was to evaluate factors that determine mortality in patients with chronic kidney
disease (CKD) who have undergone percutaneous coronary intervention (PCI).
METHODS: In this study we included 293 consecutive patients with CKD who
underwent PCI between 1st January 2007 and 30th September 2012. The primary
outcome that we studied was all-cause mortality in a follow-up period of 12-69
months (mean 38.8 ± 21.7). RESULTS: Age (p < 0.001), PCI indication (p = 0.035),
CKD stage (p < 0.001) and left ventricular ejection fraction (p < 0.001) were
significantly related to mortality. CKD stage 5 [hazard ratio (HR) = 6.39, 95%
CI: 1.51-27.12) and severely impaired left ventricular function (HR = 4.04, 95%
CI: 2.15-7.59) were the strongest predictors of mortality. Other factors tested
(gender, hypertension, diabetes, hyperlipidaemia, established peripheral vascular
disease/stroke, coronary arteries intervened, number of vessels treated, number
of stents implanted and length of lesion treated) did not show any correlation
with mortality. CONCLUSIONS: The mortality of patients with CKD undergoing PCI
increases with age, worsening CKD stage and deteriorating left ventricular
systolic function, and it is also higher in patients with acute coronary
syndromes compared to those with stable coronary artery disease.