Determinants of Mortality in Patients with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention.
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.
Department of Cardiology, King's College London, London, UK.
Alexandros
A
Papachristidis
Renal Department, Royal Free Hospital, King's College London, London, UK.
Wei Yao
WY
Lim
Department of Cardiology, King's College London, London, UK.
Christos
C
Voukalis
Department of Primary Care and Public Health Sciences, King's College London, London, UK.
Salma
S
Ayis
Renal Department, Royal Free Hospital, King's College London, London, UK.
Christopher
C
Laing
Department of Cardiology, King's College London, London, UK.
Roby D
RD
Rakhit
Cardiovascular disease; Chronic renal failure; Glomerular filtration rate; Kidney disease; Mortality; Percutaneous coronary intervention; Renal impairment