Prognostic analysis of patients with left main coronary artery disease complicated by chronic kidney disease undergoing intravascular ultrasound-guided coronary intervention therapy
10.3969/j.issn.1004-8812.2025.09.003
- VernacularTitle:左主干冠状动脉疾病合并慢性肾病行血管内超声指导的冠状动脉介入治疗患者预后分析
- Author:
Dong YI
1
;
Chen-wei MENG
1
;
Xun JIAN
1
;
Dao-quan LIU
1
;
Lin XU
1
;
Ting LUO
1
;
Hua YAN
1
Author Information
1. 武汉亚洲心脏病医院心内科,湖北武汉 430022
- Publication Type:Journal Article
- Keywords:
Left main coronary artery disease;
Chronic kidney disease;
Coronary intervention;
Intravascular ultrasound;
Prognosis
- From:
Chinese Journal of Interventional Cardiology
2025;33(9):500-508
- CountryChina
- Language:Chinese
-
Abstract:
Objective To elucidate the impact of chronic kidney disease(CKD)on the clinical outcomes of patients with left main coronary artery disease(LMCAD)undergoing intravascular ultrasound(IVUS)-guided percutaneous coronary intervention(PCI).Methods This retrospective study enrolled consecutive patients with LMCAD who underwent IVUS-guided PCI at Wuhan Asia Heart Hospital between January 2017 and December 2020.Patients were stratified into CKD and non-CKD groups according to the presence of CKD.Clinical data were systematically retrieved from the electronic health record system.Demographic,clinical,and angiographic characteristics were compared between groups.The primary endpoint was major adverse cardiovascular events(MACE),defined as a composite of all-cause mortality,myocardial infarction,and ischemic stroke.Results A total of 325 LMCAD patients[mean age(62.56±9.86)years;73.54％male]were included,with 31 patients(9.54％)in the CKD group.During a median follow-up of 5 years,CKD patients exhibited significantly older age[(70.13±9.77)years vs.(61.77±9.54)years,P＜0.001],higher prevalence of three-vessel disease(64.52％vs.38.10％;P=0.040)and left main bifurcation lesion(45.16％vs.37.76％,P=0.011),greater IVUS-detected calcification burden(P=0.029),and higher median SYNTAXⅡ scores[(34.10(30.30,39.25)vs.26.75(22.42,31.58),P＜0.001)].The cumulative incidence of MACE was significantly higher in the CKD group compared to the non-CKD group(32.26％vs.9.18％,P＜0.001).Univariate Cox regression analysis and Kaplan-Meier survival curves confirmed a 5.877-fold increased risk of MACE in CKD patients(95％CI 2.765-12.494).After adjusting for age and cardiac function,CKD remained an independent predictor of MACE(HR 3.611,95％CI 1.634-7.978).Conclusions LMCAD patients with concomitant CKD present with advanced age,impaired cardiac function,more extensive coronary disease,and severe calcification.The presence of CKD is associated with a significantly worse long-term prognosis.
