Abstract 21405: Low Post-Procedural Estimated Glomerular Filtration Rate Predicts Higher Rates of Restenosis in Patients Undergoing Primary Angioplasty for Peripheral Artery Disease
Introduction: There are limited data on the association of peri-procedural change in eGFR and 1-year restenosis in patients with PAD undergoing angioplasty.
Objectives: We sought to estimate the association of post-procedural eGFR with rate of restenoses.
Methods: We carried out a cross-sectional study of 92 patients who underwent primary angioplasty with stenting for PAD in a large urban tertiary care center. We abstracted data on demographics, medication usage, laboratory parameters and follow-up. Multivariate logistic regression and Receiver Operating Curve (ROC) analyses were used to estimate the association between both pre and post procedural eGFR and 1-year restenosis
Results: Restenosis within 1 year was seen in 38(41.3%). There were no significant differences in the baseline characteristics and medication usage between the two groups. The mean post-procedure eGFR (calculated by the CKD-EPI equation) was significantly lower in patients with restenosis (49 vs. 60 ml/min/1.72m2; p = 0.04). There was no significant difference in the mean pre-procedure eGFR (53 vs. 57 ml/min/1.72m2; p = 0.38). In patients with restenosis, there was a higher peri-procedural eGFR decline (3.6 vs. 1 ml/min/1.72m2; p = 0.05). Post-procedure eGFR was associated with increased odds of restenosis (Increase in Odds Ratio of 1.02 for every 1 ml/min/1.72m2 fall in eGFR; 95% CI 1.01–1.04; p=0.05). There was no significant association between restenosis and the pre-procedure eGFR. On ROC analyses a cut point of 55 of the post-procedure eGFR was determined to be the point of maximum sensitivity and specificity for predicting restenosis. The odds of developing restenosis with a eGFR of ≤55 ml/min/1.72m2 were estimated to be 3.14 (95% CI 1.32–7.69;p=0.010).
Conclusions: Low post-procedural eGFR was significantly associated with restenosis after primary angioplasty in patients with PAD. These results aspire towards vigilant and frequent monitoring for restenosis in patients with compromised renal function post-procedure even in absence of significant renal impairment pre-procedure.
- © 2010 by American Heart Association, Inc.