Trends and In‐Hospital Outcomes of Patients With Chronic Kidney Disease Hospitalised for Acute Myocardial Infarction With Chronic Total Occlusion: A Nationwide Analysis

Chronic kidney disease (CKD) is a significant risk factor for adverse outcomes, particularly in acute myocardial infarction (AMI). Despite this, there remains a paucity of data on associations between CKD in patients with chronic total occlusion (CTO) related AMI. We examined the 2016–2020 Nationwide Readmissions Database and identified patients with AMI‐CTO. In‐hospital outcomes were compared between patients with and without CKD. The primary outcome was inpatient mortality. Secondary outcomes included odds of all‐cause 90‐day readmissions, acute kidney injury (AKI) requiring dialysis, total/time to coronary artery bypass graft (CABG), total/time to percutaneous coronary intervention (PCI), length of stay (LOS) and total hospitalisation charges (THC). Multivariate and Cox regression models were used to adjust for confounders. Amongst patients with AMI‐CTO ( N = 13 083), 31% had CKD. CKD was associated with higher odds of in‐hospital mortality (adjusted OR [aOR] 1.42, 95% CI 1.19–1.69), AKI requiring dialysis (aOR 2.27, 95% CI 1.69–3.04), longer LOS (13 vs. 10 days) and higher THC ($291 965 vs. $255 552) and lower odds of CABG (aOR 0.78, 95% CI 0.64–0.96) compared to non‐CKD patients. No difference was observed in odds of all cause 90‐day readmissions, total PCI and time to PCI/CABG between both groups. Amongst patients undergoing AMI‐CTO, CKD was associated with higher odds of mortality, non‐fatal adverse events and lower CABG use compared to non‐CKD patients.