title: Five-year mortality outcomes in patients with chronic kidney disease undergoing percutaneous coronary intervention.
abstract: OBJECTIVE
  To examine peri-procedural and long-term outcomes in patients with chronic kidney disease (CKD) undergoing percutaneous coronary interventions (PCI).
  
  
  BACKGROUND
  Patients with advanced CKD are considered high risk when undergoing PCI. Limited published data exist on quantifying risk and assessment of long-term outcomes after PCI in this group.
  
  
  METHODS
  Examining the Cornell Coronary Registry, we prospectively collected data of 6,478 consecutive patients who underwent elective or urgent PCI between 2009 and 2013. Patients were grouped into CKD stages by estimated glomerular filtration rate (eGFR) according to KDOQI guidelines. Procedural and 30-day outcomes are reported with assessment of long-term differences in 5-year all-cause mortality.
  
  
  RESULTS
  Patients were grouped by CKD stages: 1,351 patients with eGFR ≥90 mL/min/1.73 m2(stage 1), 2,882 with eGFR 60-89 (stage 2), 1,742 with eGFR 30-59 (stage 3), 191 with eGFR 15-29 (stage 4), and 312 with eGFR <15 or on dialysis (stage 5). The incidence of post-procedural acute heart failure, stroke, new dialysis requirement, transfusions, and bleeding events were higher in patients with greater CKD stage (P < 0.05). Five-year Kaplan-Meier overall survival among CKD stages 1-5 was 98.1, 95.5, 91.8, 82.5, and 76.9%, respectively (P < 0.001 by log-rank test). The hazard ratios of all-cause mortality for CKD stages 2-5 as compared to stage 1 by multivariate Cox regression analysis were as follows: 1.32 (P = 0.26), 2.04 (P < 0.01), 2.79 (P < 0.01), and 5.49 (P < 0.001).
  
  
  CONCLUSIONS
  Among patients undergoing PCI, lower GFR is associated with decreased long-term survival. © 2016 Wiley Periodicals, Inc.
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Agam D
authors: AD
authors: Patel
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Mohammed
authors: M
authors: Ibrahim
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Rajesh V
authors: RV
authors: Swaminathan
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Irfan U
authors: IU
authors: Minhas
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Luke K
authors: LK
authors: Kim
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Prashanth
authors: P
authors: Venkatesh
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Dmitriy N
authors: DN
authors: Feldman
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Robert M
authors: RM
authors: Minutello
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Geoffrey W
authors: GW
authors: Bergman
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: S Chiu
authors: SC
authors: Wong
authors: Division of Cardiology, New York Presbyterian Hospital/Weill Cornell Medicine, New York, New York.
authors: Harsimran S
authors: HS
authors: Singh
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention; D016016:Proportional Hazards Models; D012042:Registries; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: chronic kidney disease; mortality; outcomes; percutaneous coronary intervention