Safety of percutaneous coronary intervention in patients with acute coronary syndromes complicating chronic kidney disease
10.3760/cma.j.issn.0253-3758.2015.10.003
- VernacularTitle:急性冠状动脉综合征合并慢性肾脏病患者行经皮冠状动脉介入治疗的安全性
- Author:
Yuan FU
1
;
Kuibao LI
;
Xinchun YANG
Author Information
1. 100020,首都医科大学附属北京朝阳医院心脏中心
- Keywords:
Coronary disease;
Kidney diseases;
Angioplasty,transluminal,percutaneous coronary
- From:
Chinese Journal of Cardiology
2015;43(10):848-853
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the safety of percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS) complicating chronic kidney disease (CKD).Methods We retrospectively evaluated the medical data of 335 patients hospitalized in our hospital with a diagnosis of ACS and CKD between 1 January 2011 and 30 May 2014.Patients were divided into two groups: PCI group who received PCI treatment during hospitalization (n =135) and non-PCI group who did not receive PCI treatment (n =200).Multivariable logistic regression analysis was performed to evaluate the connection between PCI and in-hospital death and acute renal insufficiency.Results The median GFR level of 335 patients was 36.26 (25.09-47.65) ml · min-1 · 1.73 m-2.GFR level was similar between the two groups (P =0.205).Multivariable logistic regression analysis showed that PCI did not increase the risk of inhospital death (OR =0.465,95％ CI:0.190-1.136, P =0.093) and in-hospital acute renal insufficiency (OR =0.830,95％ CI:0.375-1.836, P =0.669).In patients of 45 ml · min-1 · 1.73 m-2 ≤ GFR ＜ 60 ml · min-1 · 1.73 m-2, 30 ml · min-1 · 1.73 m-2≤GFR ＜45 ml · min-1 · 1.73 m-2 and GFR ＜30 ml · min-1 · 1.73 m-2, the OR of in-hospital death in PCI group were 0.235 (95％ CI:0.024-2.301 ,P =0.213), 0.640(95％ CI:0.112-3.649,P =0.616)and 0.919(95％ CI:0.159-5.307,P =0.925) ,and the OR of in-hospital acute renal insufficiency were 0.436 (95％ CI: 0.120-1.587, P =0.208), 2.209 (95 ％ CI: 0.394-12.391, P =0.368) and 0.724 (95 ％ CI: 0.127-4.117, P =0.716) indicating that PCI did not increase above events in ACS patients complicating CKD.Conclusion PCI does not increase the risk of in-hospital death and in-hospital acute renal insufficiency in ACS patients complicating CKD.
