A-17 | Revascularization rates post percutaneous coronary intervention in chronic kidney disease patients: A meta-analysis study

Chronic kidney disease (CKD) confers worse cardiovascular (CV) outcomes. Patients are known to have increased atherosclerosis and revascularization rates due to prolonged inflammation and presence of CV risk factors. Increased revascularization after percutaneous coronary intervention (PCI) has been established in end stage renal disease patients (ESRD) and we set to evaluate outcomes in CKD patients. We conducted a systematic review and meta analysis on EMBASE, Pubmed, Cochrane, Web of Science databases to analyze studies with PCI outcomes in patients with and without CKD. Target vessel revascularization, target lesion revascularization, target lesion failure were the primary outcomes studied. 29 articles were included comprising 93190 patients. CKD patients were older ( 70.2 vs 62.6 years). The CKD cohort had higher rates of hypertension, diabetes mellitus, hyperlipidemia with 76.2%, 40% and 65% respectively and a higher prevalence of triple vessel disease ( 29.3 % vs 18% ). Median follow was 24 months.17 studies evaluated target vessel revascularization, showing a non significant risk increase in CKD patients with a risk ratio of 1.14 (95% CI 1 – 1.29). 12 studies evaluated target lesion revascularization, showing a cumulative significant increased risk in CKD patients with a risk ratio of 1.16 (95% CI 1.02-1.32), p=0.02. But the risk was non significant in the randomized controlled trial subgroup analysis as shown in figure 1. Although presence of CKD has higher prevalence of triple vessel disease, it does not affect long term revascularization rates in patients undergoing PCI.