title: Grade of chronic renal failure, and acute and long-term outcome after percutaneous coronary interventions.
abstract: BACKGROUND
  Patients with moderate chronic renal failure have recently been identified to suffer from a markedly higher mortality after percutaneous coronary intervention (PCI). We focused on the outcome of PCI patients with just mildly elevated creatinine levels of 1.1 to 1.5 mg/dL.
  
  
  METHODS
  Data of all PCI patients of the years 1998 to 1999 were analyzed. Follow-up was performed by a questionnaire sent to all patients.
  
  
  RESULTS
  During this period, PCI was performed in 1049 patients. Long-term follow-up (1184 +/- 10 days) was 99.6% complete. Total mortality increased continuously by each creatinine increment of 0.1 mg/dL above 1.0 mg/dL, with a significant difference at 1.3 mg/dL compared to patients with <or=1.0 mg/dL (12.4 vs. 5.5%, P < 0.05). In a Kaplan-Meier model, patients with a creatinine of 1.3 to 1.4 mg/dL had a significantly lower cumulative survival after three years (87%) than controls (96%, P = 0.0108, log rank test). Higher serum creatinine levels were found to be significantly associated with death in univariate analysis (1.1 +/- 0.4 vs. 1.5 +/- 1.0 mg/dL, P < 0.00001), and in multivariate analysis by stepwise logistic regression (OR 2.122, 95% CI 1.585 to 2.841).
  
  
  CONCLUSIONS
  In this retrospective cross-sectional study, even patients with slightly elevated serum creatinine levels of 1.3 to 1.4 mg/dL had a significantly reduced long-term outcome after PCI. Thus, even mild chronic renal failure appears to be associated with markedly increased risk after a PCI, with implications to the high number of patients concerned.
authors.affiliation: Department of Cardiology and Angiology, Medizinische Klinik und Poliklinik C, University Hospital Münster, Münster, Germany. reinech@uni-muenster.de
authors.forename: Holger
authors.initials: H
authors.lastname: Reinecke
authors.forename: Torsten
authors.initials: T
authors.lastname: Trey
authors.forename: Fritz
authors.initials: F
authors.lastname: Matzkies
authors.forename: Manfred
authors.initials: M
authors.lastname: Fobker
authors.forename: Günter
authors.initials: G
authors.lastname: Breithardt
authors.forename: Roland M
authors.initials: RM
authors.lastname: Schaefer
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D019540:Area Under Curve; D003327:Coronary Disease / Q000150:complications* / Q000628:therapy*; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000150:complications* / Q000401:mortality* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012372:ROC Curve; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D003404:Creatinine