Key result
Severe renal impairment in ACS patients treated with PCI was associated with an increased frequency of late MACE compared to normal or milder impairment (p=0.001).
Why the study?
Does renal impairment worsen short- and long-term outcomes in ACS patients treated with PCI?
Cohort (n=427)
Does renal impairment worsen short- and long-term outcomes in ACS patients treated with PCI?
Answers are grounded in this paper and cite their sources.
Severe renal impairment is a strong predictor of suboptimal procedural results and adverse short- and long-term clinical outcomes in ACS patients undergoing PCI.
Objective:Impact of renal impairment (RI) on short&long term outcome of percutaneous coronary intervention (PCI) in patients with ACS. Methods: 427 patients with ACS, treated with PCI .They were classified into 4 groups (normal , mild, moderate and severe renal impairment) based on creatinine clearance (eCrCl).MACE including death, new myocardial infarction (MI) and target vessel revascularization (TVR) were recorded during early (30 days) and late for average 49months. Results:Patients with severe RI had higher number of vessels affected (p 0.023), lower grade of TIMI flow(p0.029), lower percent dilatation of culprit lesion( p<0.001), less frequent use of GPIIb/IIIa inhibitors(p0.002) and more frequent need for TVR(p0.03). eCrCl had positive correlation with EF and percent dilatation of stenotic lesion (p,0.001)and negative correlation with number of vessels & late MACE(p0.001).Patients with severe RI had increase in frequency of lateMACE compared to other groups(p0.001).TypeC lesions were more common in patients with advanced RI(p0.03).MACE free survival showed significant decline matching the decline in eCrCl among study groups. Conclusion: PCI outcome in patients with severe RI was suboptimal.They had increased riskof TVR within one month and increased riskof MI,death and total MACE on the long term.
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Radwan et al. (2016) conducted a cohort in Acute Coronary Syndrome (n=427). Renal impairment vs. Normal renal function was evaluated on MACE including death, new myocardial infarction (MI) and target vessel revascularization (TVR) (p=0.001). Severe renal impairment in ACS patients treated with PCI was associated with an increased frequency of late MACE compared to normal or milder impairment (p=0.001).
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