Abstract 10622: Impact of Acute Coronary Syndrome on Clinical Outcomes in Patients With Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention
Background: Patients who undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) have poor prognosis than stable coronary artery disease (CAD). Few studies to compare the impact of ACS between patients without chronic kidney disease (CKD) and with CKD are present. The aim of this study was to compare the long-term clinical events after percutaneous coronary intervention (PCI) between patients with ACS and with stable CAD according to the presence of CKD.
Methods: We enrolled consecutive 5963 patients who had undergone PCI and retrospectively collected clinical, laboratory and angiographic data. CKD was defined as eGFR <60mL/min/1.73m2. The primary endpoint was the major adverse cardiac events (MACE: cardiac death, myocardial infarction or target lesion revascularization).
Results: Among 5963 patients, 879 (14.7%) had CKD and 5084 (85.3%) had preserved kidney function. The MACE rate was higher in CKD patients than Non-CKD patients during a median follow-up of 48 months (22.3% vs. 10.0%, p<0.001). Cox proportional-hazard analysis showed that ACS was significantly associated with a higher incidence of MACE in patients both without CKD (adjusted hazard ratio [HR] 1.3, 95% CI 1.1-1.6, p=0.003) and with CKD (adjusted HR 1.9, 95% CI 1.4-2.5, p<0.001). Significant interaction was shown between patients without CKD and those with CKD for the incidence of MACE after adjusted statistically and clinically important covariates (p=0.041).
Conclusion: ACS is associated with higher incidence of cardiovascular events than stable CAD after coronary revascularization. In CKD patients, the adverse effect of ACS on cardiovascular outcomes is augmented.
- © 2013 by American Heart Association, Inc.