Does the stage of chronic kidney disease impact the risk of net adverse clinical events in patients with atrial fibrillation after percutaneous coronary intervention?
In patients with atrial fibrillation undergoing PCI, advanced chronic kidney disease is associated with a significantly higher 1-year risk of net adverse clinical events, primarily driven by increased all-cause mortality.
BACKGROUND Patients with chronic kidney disease (CKD) have an elevated risk of adverse cardiovascular events. However, the impact of different stages of CKD on the prognosis of patients with atrial fibrillation (AF) after percutaneous coronary intervention (PCI) remains uncertain. METHODS This multicenter registry included 902 patients with AF undergoing PCI. Patients were divided into 3 groups based on renal function: normal estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73m2, early CKD (30 ≤ eGFR <60 mL/min/1.73m2), and advanced CKD (eGFR <30 mL/min/1.73m2 or patients on hemodialysis). The primary endpoint was net adverse clinical events (NACE) within 1 year after PCI, a composite of all-cause death, myocardial infarction (MI), ischemic stroke, and major bleeding (Bleeding Academic Research Consortium type 3 or 5) events. RESULTS Of the 902 patients, 338 (37.5 %), 438 (48.5 %), and 126 (14.0 %) were grouped as normal, early CKD, and advanced CKD. Within the one-year follow-up period, 142 (15.7 %) patients experienced NACE after PCI. The progression of CKD was associated with increased NACE rates, mainly driven by an increased risk of all-cause death. There were no significant differences in the rates of MI, ischemic stroke, and major bleeding events among the three groups. CONCLUSIONS Advanced CKD was significantly associated with a higher incidence of NACE compared with early CKD or normal renal function in patients with AF after PCI.
Yaginuma et al. (Thu,) studied this question.