Adverse impact of chronic kidney disease on clinical outcomes following percutaneous coronary intervention
Jason E Bloom BSc, MBBS
Department of Cardiology, Alfred Health, Melbourne, Australia
Department of Cardiology, Bendigo Health, Bendigo, Australia
Search for more papers by this authorDiem T Dinh BSc, PhD
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorSamer Noaman MBChB
Department of Cardiology, Alfred Health, Melbourne, Australia
Department of Cardiology, Western Health, Melbourne, Australia
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Search for more papers by this authorCatherine Martin PhD
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorMichael Lim MBBS
Department of Cardiology, Geelong University Hospital, Geelong, Australia
Search for more papers by this authorRiley Batchelor MBBS
Department of Cardiology, Alfred Health, Melbourne, Australia
Search for more papers by this authorWayne Zheng
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Search for more papers by this authorChristopher Reid B.A, Dip Ed, MSc, PhD
School of Public Health, Curtin University, Perth, Australia
Search for more papers by this authorAngela Brennan RN
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorJeffrey Lefkovits MBBS
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Royal Melbourne Hospital, Melbourne, Australia
Search for more papers by this authorNicholas Cox MBBS
Department of Cardiology, Western Health, Melbourne, Australia
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Search for more papers by this authorStephen J Duffy MBBS, PhD
Department of Cardiology, Alfred Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Monash University, Melbourne, Australia
Search for more papers by this authorCorresponding Author
William Chan MBBS, PhD
Department of Cardiology, Alfred Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Department of Cardiology, Western Health, Melbourne, Australia
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Monash University, Melbourne, Australia
Baker Heart and Diabetes Institute, Melbourne, Australia
Correspondence
William Chan, Department of Cardiology, Western Health, St Albans, Victoria 3021, Australia.
Email: [email protected]
Search for more papers by this authorJason E Bloom BSc, MBBS
Department of Cardiology, Alfred Health, Melbourne, Australia
Department of Cardiology, Bendigo Health, Bendigo, Australia
Search for more papers by this authorDiem T Dinh BSc, PhD
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorSamer Noaman MBChB
Department of Cardiology, Alfred Health, Melbourne, Australia
Department of Cardiology, Western Health, Melbourne, Australia
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Search for more papers by this authorCatherine Martin PhD
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorMichael Lim MBBS
Department of Cardiology, Geelong University Hospital, Geelong, Australia
Search for more papers by this authorRiley Batchelor MBBS
Department of Cardiology, Alfred Health, Melbourne, Australia
Search for more papers by this authorWayne Zheng
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Search for more papers by this authorChristopher Reid B.A, Dip Ed, MSc, PhD
School of Public Health, Curtin University, Perth, Australia
Search for more papers by this authorAngela Brennan RN
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Search for more papers by this authorJeffrey Lefkovits MBBS
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Royal Melbourne Hospital, Melbourne, Australia
Search for more papers by this authorNicholas Cox MBBS
Department of Cardiology, Western Health, Melbourne, Australia
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Search for more papers by this authorStephen J Duffy MBBS, PhD
Department of Cardiology, Alfred Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Monash University, Melbourne, Australia
Search for more papers by this authorCorresponding Author
William Chan MBBS, PhD
Department of Cardiology, Alfred Health, Melbourne, Australia
School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
Department of Cardiology, Western Health, Melbourne, Australia
Department of Medicine-Western Health, Melbourne Medical School, University of Melbourne, Melbourne, Australia
Monash University, Melbourne, Australia
Baker Heart and Diabetes Institute, Melbourne, Australia
Correspondence
William Chan, Department of Cardiology, Western Health, St Albans, Victoria 3021, Australia.
Email: [email protected]
Search for more papers by this authorFunding information: Monash University; Department of Health and Human Services, State Gorvernment of Victoria; Medibank Private; Victorian Department of Health
Abstract
Aims
We aimed to assess the impact of the severity of chronic kidney disease (CKD) with long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI).
Methods
We analyzed data on consecutive patients undergoing PCI enrolled in the Victorian Cardiac Outcomes Registry (VCOR) from January 2014 to December 2018. Patients were stratified into tertiles of renal function; estimated glomerular filtration (eGFR) ≥60, 30–59 and < 30 ml/min/1.73 m2 (including dialysis). The primary outcome was long-term all-cause mortality obtained from linkage with the Australian National Death Index (NDI). The secondary endpoint was a composite of 30 day major adverse cardiac and cerebrovascular events.
Results
We identified a total of 51,480 patients (eGFR ≥60, n = 40,534; eGFR 30–59, n = 9,521; eGFR <30, n = 1,425). Compared with patients whose eGFR was ≥60, those with eGFR 30–59 and eGFR<30 were on average older (77 and 78 vs. 63 years) and had a greater burden of cardiovascular risk factors. Worsening CKD severity was independently associated with greater adjusted risk of long-term NDI mortality: eGFR<30 hazard ratio 4.21 (CI 3.7–4.8) and eGFR 30–59; 1.8 (CI 1.7–2.0), when compared to eGFR ≥60, all p < .001.
Conclusion
In this large, multicentre PCI registry, severity of CKD was associated with increased risk of all-cause mortality underscoring the high-risk nature of this patient cohort.
CONFLICT OF INTEREST
The authors have no conflicts of interest to declare.
Open Research
DATA AVAILABILITY STATEMENT
The data that support the findings of this study are available from VCOR. Restrictions apply to the availability of these data, which were used under license for this study. Data are available DD with the permission of VCOR.
Supporting Information
| Filename | Description |
|---|---|
| ccd29436-sup-0001-Supinfo.docxWord 2007 document , 13.8 KB | Appendix S1: Supporting information. |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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