Key result
Chronic kidney disease was associated with a significantly increased risk of first-year major adverse cardiac events (OR 2.1) compared to no chronic kidney disease following PCI with drug-eluting balloons.
Why the study?
Little is known regarding the outcomes of individuals with CKD who undergo PCI with drug-eluting balloons.
Does percutaneous coronary intervention with drug-eluting balloons result in different cardiovascular outcomes in patients with chronic kidney disease compared to those without?
Cohort (n=362)
No
Does percutaneous coronary intervention with drug-eluting balloons result in different cardiovascular outcomes in patients with chronic kidney disease compared to those without?
Odds Ratio: 2.1 (95% CI 1–4.3)
Absolute Event Rate: 23.8% vs 13.8%
p-value: p=<0.001
In patients undergoing PCI with drug-eluting balloons, the presence of chronic kidney disease is associated with a significantly higher risk of first-year MACE and myocardial infarction, despite similar rates of target lesion revascularization.
Supports heightened post-procedural surveillance in CKD; leaves open whether dedicated protocols improve drug-eluting balloon PCI outcomes.
BACKGROUND: Chronic kidney disease (CKD) is associated with poorer outcomes following percutaneous coronary intervention (PCI) with drug-eluting stents. Drug-eluting balloons are used for in-stent restenosis and selected cases of de-novo coronary lesions. Little is known regarding the outcomes of individuals with CKD who undergo PCI with drug-eluting balloons. The goal of this study was to assess outcomes of PCI with drug-eluting balloons in individuals with CKD. METHODS: . We compared demographics, procedure data and clinical outcomes in the first and second years following the procedure. RESULTS: Rates of major adverse cardiac events (MACE) and myocardial infarction were higher in patients with than without CKD: 23.8% vs. 13.8%, P < 0.005 and 15.9% vs. 3.8%, P < 0.001, respectively. Rates of target lesion revascularization were similar, 14.9 and 11.5%, respectively, P = 0.4. Shorter duration of dual anti-platelet therapy was observed among patients with than without CKD (10.0 + 3.4 vs. 10.9 + 3.7 months, P < 0.05). First-year hemorrhage episodes were similar in the two groups (0.08 ± 0.4 and 0.03 ± 0.2, respectively, P = 0.2). In a multivariate regression analysis, CKD was associated with increased risks of first year MACE (OR 2.1; 95% confidence interval 1.0-4.3, P < 0.001). CONCLUSIONS: PCI with drug-eluting balloons was associated with increased cardiovascular morbidity and mortality in patients with than without CKD. However, rates of target lesion revascularization were similar in the two groups. Shorter duration of dual anti-platelet therapy was observed in the CKD group.
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Jonas et al. (2020) conducted a cohort in Ischemic heart disease (n=362). Chronic kidney disease vs. No chronic kidney disease was evaluated on First-year major adverse cardiac events (MACE) (OR 2.1, 95% CI 1.0-4.3, p=<0.001). Chronic kidney disease was associated with a significantly increased risk of first-year major adverse cardiac events (OR 2.1) compared to no chronic kidney disease following PCI with drug-eluting balloons.
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