Key result
CKD alone linked to ~186% greater all-cause mortality versus no CKD or hypertension post-PCI.
Why the study?
The effects of chronic kidney disease and hypertension on long-term outcomes in patients with stable coronary artery disease receiving percutaneous coronary intervention were unclear.
Does the presence of chronic kidney disease and/or hypertension affect long-term outcomes in patients with stable coronary artery disease receiving percutaneous coronary intervention?
Cohort (n=1,676)
No
Does the presence of chronic kidney disease and/or hypertension affect long-term outcomes in patients with stable coronary artery disease receiving percutaneous coronary intervention?
Hazard Ratio: 2.86 (95% CI 1.73–4.75)
Absolute Event Rate: 29.3% vs 6.2%
p-value: p=<0.01
In patients with stable CAD undergoing PCI, comorbid CKD alone is associated with the highest long-term mortality, while the combination of CKD and HT increases the risk of repeat PCI.
CKD flags high-mortality subgroup post-PCI; leaves open whether targeted interventions modify risk in observational data.
Percutaneous coronary intervention (PCI) is commonly used for patients with coronary artery disease (CAD). However, the effects of chronic kidney disease (CKD) and hypertension (HT) on long-term outcomes in patients with stable CAD receiving PCI are still unclear. A total of 1,676 patients treated with PCI were prospectively enrolled and divided into 4 groups according to the presence or absence of HT or CKD. General characteristics, clinical medications, risk factors, angiographic findings, and long-term outcomes were analyzed. Patients with CKD had the highest rate of all-cause and cardiovascular (CV) mortality (both P < 0.01). Patients with CKD alone had the lowest event-free rate of all-cause and CV deaths (both P < 0.001). Based on Cox proportional hazard model, patients with CKD alone had the highest risk of all-cause death (HR:2.86, 95% CI:1.73-4.75) and CV death (HR: 3.57,95% CI:2.01-6.33); while patients with both CKD and HT had the highest risk of repeat PCI (HR: 1.42, 95% CI:1.09-1.85).We found that in stable CAD patients after undergoing PCI, those with CKD alone had the highest long-term mortality. Comorbid CKD appears to increase risk in patient with HT, whereas comorbid HT doesn't seem to increase risk in patients with CKD.
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Lin et al. (2018) conducted a cohort in Stable coronary artery disease (n=1,676). Chronic kidney disease (CKD) alone vs. Patients without hypertension and chronic kidney disease was evaluated on All-cause mortality (HR 2.86, 95% CI 1.73-4.75, p=<0.01). In patients with stable coronary artery disease undergoing percutaneous coronary intervention, chronic kidney disease alone was associated with a significantly increased risk of all-cause mortality (HR 2.86) compared to patients without hypertension or chronic kidney disease.
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