Key result
Single-vessel disease PCI was protective against cardiac death (OR 0.612) in elderly patients with severe chronic kidney disease, while stable angina and lack of statins were risk factors.
Why the study?
Risk factors for cardiac death in elderly patients with severe chronic kidney disease and coronary atherosclerotic heart disease following percutaneous coronary intervention needed to be identified.
Cohort (n=1,010)
No
Odds Ratio: 0.612 (95% CI 0.416–0.899)
p-value: p=0.012
In elderly patients with severe CKD undergoing PCI, stable angina, peripheral artery disease, elevated potassium, and lack of statin therapy are independent risk factors for cardiac death.
May aid risk stratification in elderly severe CKD patients post-PCI; observational data leave causal effects and practice changes open.
Aims: To identify risk factors for cardiac death of elderly and severe chronic kidney disease (CKD) patients with coronary atherosclerotic heart disease (CAHD) after percutaneous coronary intervention (PCI). Methods: 1010 CAHD-CKD patients over 60 years old who had CKD stage 3 or above and underwent PCI were followed up for at least 3 years. Cases of cardiac death were divided into groups. After univariate analysis of all variables, the variables with P < .2 were selected for further logistic regression. Results: For logistic regression single-vessel disease (SVD) PCI OR = 0.612, 95%CI: 0.416–0.899, P = .012, it is the protective factor. There are four risk factors, stable angina pectoris (SAP) OR = 4.723, 95%CI: 1.098∼20.322, P = .037, combined with lower extremity arteriosclerosis obliterans (LEASO) OR = 2.631, 95%CI: 1.272∼5.440, P = .009, K > 4.285 mmol/L OR = 1.44, 95%CI: 1.002∼2.069, P = .049, without statins OR = 2.015, 95%CI: 1.072∼3.789, P = .030. Conclusion: In elderly and serious CAHD-CKD patients after PCI, SVD PCI was a protective factor against cardiac death. However, SAP, CAHD-CKD combined with LEASO, K > 4.285 mmol/L, and no statins were independent risk factors of cardiac death for elderly patients with severe CKD after PCI.
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Zhang et al. (2022) conducted a cohort in Coronary atherosclerotic heart disease and severe chronic kidney disease (n=1,010). Single-vessel disease percutaneous coronary intervention (SVD PCI) vs. Non-single-vessel disease PCI was evaluated on Cardiac death (OR 0.612, 95% CI 0.416-0.899, p=0.012). Single-vessel disease PCI was protective against cardiac death (OR 0.612) in elderly patients with severe chronic kidney disease, while stable angina and lack of statins were risk factors.
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