Kidney transplant recipients (KTRs) face high cardiovascular risk, yet outcomes after percutaneous coronary intervention (PCI) remain poorly characterized. We compared in-hospital outcomes, temporal trends, and predictors of mortality between KTRs and non-transplant patients undergoing PCI. Using the National Inpatient Sample (2016-2021), we identified adult PCI hospitalizations and classified them as KTRs or non-transplant patients. Outcomes included in-hospital mortality, acute kidney injury (AKI), bleeding, length of stay (LOS), and hospitalization costs. Propensity-score matching (PSM) reduced baseline differences, and multivariable logistic regression identified mortality predictors among KTRs. Of 2 677 410 PCI hospitalizations, 8300 involved KTRs. KTRs were younger but had higher comorbidity burden. Unadjusted mortality was higher in KTRs (3.55% vs 2.98%), but not after matching (PSM odds ratio OR 0.89; 95% CI, 0.67-1.20). KTRs had higher AKI risk (25.7% vs 16.1%; PSM OR 1.25; 95% CI, 1.10-1.42), whereas AKI requiring dialysis did not differ. Excess bleeding and transfusion in unadjusted analyses were attenuated after matching. KTRs had longer LOS and higher costs. Despite similar in-hospital mortality, KTRs undergoing PCI experience greater AKI risk and resource use, supporting tailored risk stratification and post-procedural monitoring in this population.
Ang et al. (2026) studied this question.