Impact of race and chronic kidney disease on 1-year outcome in patients undergoing percutaneous coronary interventions: a single tertiary center experience.
BACKGROUND
Chronic kidney disease (CKD) is a predictor of morbidity and mortality in patients undergoing percutaneous coronary interventions (PCIs), and African American (AA) patients have been reported to have worse outcomes after PCI.


METHODS
We assessed whether CKD affects the rate of death and major adverse cardiovascular events (MACE = myocardial infarction, revascularization, and death) differently in AA and white (CC) patients 1 year after PCI. Accordingly, we reviewed the database of all patients referred for PCI in the Emory Healthcare System between January 2001 and December 2004.


RESULTS
We identified 800 CC and 116 AA patients with CKD among 4,372 patients referred for PCI. Chronic kidney disease was defined as an estimated glomerular filtration rate (eGFR) <60 mL/(min 1.73 m(2)) calculated by means of the Cockcroft-Gault equation. The AA patients with CKD were younger and had a larger number of comorbidities than the CC subjects. However, neither mortality nor MACE differed between races (14.7% vs 13.1%, P = .65 and 31.9% vs 31.3%, P = .89, respectively). In multivariable models, eGFR and emergency PCI were the best predictors of any adverse event, whereas prior PCI or coronary artery bypass surgery was a predictor of MACE alone. A test for interaction failed to show a significant effect of race and CKD on outcome.


CONCLUSIONS
In a tertiary referral center, AA and CC patients with CKD had a similar mortality rate and MACE at 1 year after PCI. Race was not a determinant of outcome, whereas CKD was.
Department of Medicine and Division of Cardiology, Emory University, Atlanta, GA, USA.
Francesca
F
Cardarelli
Antonio
A
Bellasi
Emir
E
Veledar
Viola
V
Vaccarino
Paolo
P
Raggi
D001741:Black or African American; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome; D044465:White People