Impact of Chronic Kidney Disease on Long-Term Outcome in Coronary Bypass Candidates Treated with Percutaneous Coronary Intervention.
OBJECTIVE
The aim of this study was to identify clinical, lesional, and procedural predictors for adverse outcomes of coronary angioplasty and stenting in coronary bypass candidates.


METHODS
This cohort study included 107 consecutive candidates for coronary artery bypass surgery who underwent percutaneous coronary intervention with multiple coronary stents between Jan 2004 and Dec 2011. The study endpoint was major adverse cardiovascular events (MACEs) including all-cause mortality, nonfatal myocardial infarction, repeat revascularization, and stent thrombosis. Follow up was from the date of index percutaneous coronary intervention to the date of the first MACE, date of death, or December 31, 2015, whichever came first.


RESULTS
In this study (age 62.3±11.2 years, 86% male), 38 patients (36%) had MACE. Among baseline, angiographic, and procedural parameters, there were significant differences in lower left ventricular ejection fraction (LVEF) and worse renal function. In a Cox regression model, LVEF and chronic kidney disease (CKD) were significant predictors for MACE. After a multivariate adjustment, CKD remained a significant predictor of MACEs (hazard ratio: 2.97, 95% confidence interval: 1.50-5.90).


CONCLUSIONS
For coronary bypass candidates who were treated with coronary angioplasty and stenting, CKD seems to be the strongest predictor for adverse outcomes compared with other traditional factors.
Division of Cardiovascular, Department of Internal Medicine, Chang Gung University, Taoyuan, Taiwan.
Jian-Rong
JR
Peng
Division of Cardiovascular, Department of Internal Medicine, Chang Gung University, Taoyuan, Taiwan.; Cardiovascular Intervention Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.; Chang Gung University, College of Medicine, Taoyuan, Taiwan.
Chi-Jen
CJ
Chang
Division of Cardiovascular, Department of Internal Medicine, Chang Gung University, Taoyuan, Taiwan.; Chang Gung University, College of Medicine, Taoyuan, Taiwan.
Chun-Li
CL
Wang
Division of Cardiovascular, Department of Internal Medicine, Chang Gung University, Taoyuan, Taiwan.
Ying-Chang
YC
Tung
Division of Cardiovascular, Department of Internal Medicine, Chang Gung University, Taoyuan, Taiwan.; Cardiovascular Intervention Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Hsin-Fu
HF
Lee
Chronic kidney disease; Coronary angioplasty, bypass surgery; Coronary artery disease