title: Renal failure after percutaneous coronary intervention is associated with high mortality.
abstract: Renal failure is a marker of poor outcome in the general population. Renal failure after percutaneous coronary artery intervention (PCI) is associated with an increased hazard of in-hospital mortality. We hypothesized that post-PCI renal insufficiency would be a predictor of long-term mortality in patients undergoing PCI who survive for over 30 days after the procedure. A retrospective analysis was conducted from a registry of 9,067 patients undergoing PCI at our center from 1997 to 2001. A rise in creatinine by 1 mg/dl from baseline was defined as post-PCI renal insufficiency. Vital status was assessed using Social Security Death Index. There were a total of 996 deaths over a mean follow-up period of 3.2 years. In a multivariate analysis, history of recent acute myocardial infarction, older age, insulin-dependent diabetes, baseline creatinine greater than 1.5 mg/dl, and presence of mitral regurgitation were associated with post-PCI renal insufficiency. Developing post-PCI renal insufficiency was associated with a 4.31-fold hazard of mortality in univariate analysis and a 1.77-fold hazard after adjustment for known predictors of mortality after PCI. The 1-year survival in patients with renal failure was 70.3% +/- 3.91%, compared to a survival of 93.6% +/- 0.27% in those without any post-PCI renal insufficiency (P < 0.0001). Acute renal insufficiency after PCI is a strong and independent predictor of long-term mortality in patients who survived for 30 days after the procedure.
authors.affiliation: Division of Cardiology, Department of Medicine, University of Alabama, Birmingham, USA.
authors.forename: Ritesh
authors.initials: R
authors.lastname: Gupta
authors.forename: Hitinder S
authors.initials: HS
authors.lastname: Gurm
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.forename: Derek P
authors.initials: DP
authors.lastname: Chew
authors.forename: Stephen G
authors.initials: SG
authors.lastname: Ellis
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality* / Q000503:physiopathology; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D002423:Cause of Death; D017023:Coronary Angiography / Q000379:methods; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011336:Probability; D016016:Proportional Hazards Models; D012042:Registries; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D015607:Stents