Comparison of Propensity Score-Matched Analysis of Acute Kidney Injury After Percutaneous Coronary Intervention With Transradial Versus Transfemoral Approaches.
Transradial percutaneous coronary intervention (TR-PCI) may be associated with reduced rates of acute kidney injury (AKI). There is limited data from real-world registries about AKI rates stratified by PCI access. Our aim was to evaluate AKI rates and correlates in TR-PCI versus transfemoral PCI (TF-PCI) in a propensity score-matched analysis of patient data from a large, single-center registry. We performed a 1:1 propensity score-matched analysis on consecutive patients who underwent PCI from January 2011 to June 2016, excluding those on dialysis. A multivariate logistic regression model was adjusted to variables found to be significant in univariate models. AKI was defined by creatinine increase of ≥0.3 mg/dL post-PCI during hospitalization. During the study period, 6,743 patients underwent PCI (TR-PCI n = 1,119). Initial univariate models revealed significant differences between patients with TF-PCI and TR-PCI. Contrast amount and procedure duration were both increased with TR-PCI versus TF-PCI (162 vs 154 ml, p = 0.003; and 86 vs 79 minutes, p <0.001, respectively). Multivariate propensity score analysis matched 536 pairs of patients. In this matched cohort, TR-PCI was associated with a reduced risk for AKI compared with TF-PCI in univariate (4.3% vs 10.4%, p <0.001) and multivariate adjusted models (odds ratio 0.28, 95% confidence interval 0.19 to 0.59, p <0.001).
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Arie
A
Steinvil
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Hector M
HM
Garcia-Garcia
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Toby
T
Rogers
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Eddie
E
Koifman
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Kyle
K
Buchanan
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
M Chadi
MC
Alraies
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Rebecca
R
Torguson
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Augusto D
AD
Pichard
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Lowell F
LF
Satler
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC.
Itsik
I
Ben-Dor
Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC. Electronic address: ron.waksman@medstar.net.
Ron
R
Waksman
D058186:Acute Kidney Injury / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D004219:District of Columbia / Q000453:epidemiology; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications; D057216:Propensity Score; D017534:Radial Artery; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013997:Time Factors