title: Association of chronic renal insufficiency with in-hospital outcomes after percutaneous coronary intervention.
abstract: BACKGROUND
  The association of chronic renal insufficiency with outcomes after percutaneous coronary intervention (PCI) in the current era of drug-eluting stents and modern antithrombotic therapy has not been well characterized.
  
  
  RESULTS
  We queried the 2007-2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years who underwent PCI. Multivariable logistic regression was used to compare in-hospital outcomes among patients with chronic kidney disease (CKD), patients with end-stage renal disease (ESRD), and those without CKD or ESRD. Of 3 187 404 patients who underwent PCI, 89% had no CKD/ESRD; 8.6% had CKD; and 2.4% had ESRD. Compared to patients with no CKD/ESRD, patients with CKD and patients with ESRD had higher in-hospital mortality (1.4% versus 2.7% versus 4.4%, respectively; adjusted odds ratio for CKD 1.15, 95% CI 1.12 to 1.19, P<0.001; adjusted odds ratio for ESRD 2.29, 95% CI 2.19 to 2.40, P<0.001), higher incidence of postprocedure hemorrhage (3.5% versus 5.4% versus 6.0%, respectively; adjusted odds ratio for CKD 1.21, 95% CI 1.18 to 1.23, P<0.001; adjusted odds ratio for ESRD 1.27, 95% CI 1.23 to 1.32, P<0.001), longer average length of stay (2.9 days versus 5.0 days versus 6.4 days, respectively; P<0.001), and higher average total hospital charges ($60 526 versus $77 324 versus $97 102, respectively; P<0.001). Similar results were seen in subgroups of patients undergoing PCI for acute coronary syndrome or stable ischemic heart disease.
  
  
  CONCLUSIONS
  In patients undergoing PCI, chronic renal insufficiency is associated with higher in-hospital mortality, higher postprocedure hemorrhage, longer average length of stay, and higher average hospital charges.
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY (T.G., N.P., D.K., P.H., M.M., S.S.).
authors.forename: Tanush
authors.initials: T
authors.lastname: Gupta
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY (T.G., N.P., D.K., P.H., M.M., S.S.).
authors.forename: Neha
authors.initials: N
authors.lastname: Paul
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY (T.G., N.P., D.K., P.H., M.M., S.S.).
authors.forename: Dhaval
authors.initials: D
authors.lastname: Kolte
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY (T.G., N.P., D.K., P.H., M.M., S.S.).
authors.forename: Prakash
authors.initials: P
authors.lastname: Harikrishnan
authors.affiliation: Division of Cardiology, New York Medical College, Valhalla, NY (S.K., W.S.A., D.J., H.A.C., W.H.F., J.A.P.).
authors.forename: Sahil
authors.initials: S
authors.lastname: Khera
authors.affiliation: Division of Cardiology, New York Medical College, Valhalla, NY (S.K., W.S.A., D.J., H.A.C., W.H.F., J.A.P.).
authors.forename: Wilbert S
authors.initials: WS
authors.lastname: Aronow
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY (T.G., N.P., D.K., P.H., M.M., S.S.).
authors.forename: Marjan
authors.initials: M
authors.lastname: Mujib
authors.affiliation: Division of Cardiology, Mount Sinai Medical Center, New York, NY (C.P.).
authors.forename: Chandrasekar
authors.initials: C
authors.lastname: Palaniswamy
authors.affiliation: Department of Medicine, New York Medical College, Valhalla, NY (T.G., N.P., D.K., P.H., M.M., S.S.).
authors.forename: Sachin
authors.initials: S
authors.lastname: Sule
authors.affiliation: Division of Cardiology, New York Medical College, Valhalla, NY (S.K., W.S.A., D.J., H.A.C., W.H.F., J.A.P.).
authors.forename: Diwakar
authors.initials: D
authors.lastname: Jain
authors.affiliation: Veterans Affairs Medical Center, Washington, DC (A.A.).
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
authors.affiliation: Division of Cardiology, New York Medical College, Valhalla, NY (S.K., W.S.A., D.J., H.A.C., W.H.F., J.A.P.).
authors.forename: Howard A
authors.initials: HA
authors.lastname: Cooper
authors.affiliation: Division of Cardiology, New York Medical College, Valhalla, NY (S.K., W.S.A., D.J., H.A.C., W.H.F., J.A.P.).
authors.forename: William H
authors.initials: WH
authors.lastname: Frishman
authors.affiliation: Heart and Vascular Center, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
authors.affiliation: David Geffen School of Medicine, University of California at Los Angeles, CA (G.C.F.).
authors.forename: Gregg C
authors.initials: GC
authors.lastname: Fonarow
authors.affiliation: Division of Cardiology, New York Medical College, Valhalla, NY (S.K., W.S.A., D.J., H.A.C., W.H.F., J.A.P.).
authors.forename: Julio A
authors.initials: JA
authors.lastname: Panza
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000601:surgery; D000368:Aged; D005260:Female; D017721:Hospital Costs / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications / Q000401:mortality; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D019106:Postoperative Hemorrhage / Q000453:epidemiology / Q000209:etiology; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000401:mortality; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
keywords: chronic kidney disease; end‐stage renal disease; in‐hospital mortality; percutaneous coronary intervention; postprocedure hemorrhage