Coronary Artery Disease
The impact of renal function on the long-term clinical course of patients who underwent percutaneous coronary intervention
Article first published online: 25 JAN 2007
Copyright © 2006 Wiley-Liss, Inc.
Catheterization and Cardiovascular Interventions
Volume 69, Issue 2, pages 189–197, 1 February 2007
How to Cite
Papafaklis, M. I., Naka, K. K., Papamichael, N. D., Kolios, G., Sioros, L., Sclerou, V., Katsouras, C. S. and Michalis, L. K. (2007), The impact of renal function on the long-term clinical course of patients who underwent percutaneous coronary intervention. Cathet. Cardiovasc. Intervent., 69: 189–197. doi: 10.1002/ccd.20874
- Issue published online: 25 JAN 2007
- Article first published online: 25 JAN 2007
- Manuscript Accepted: 5 JUN 2006
- Manuscript Received: 30 MAR 2006
- Percutaneous coronary intervention (PCI);
- chronic kidney disease;
- glomerular filtration rate
Objectives: To determine the impact of the level of kidney function on the extended (>5 years) long-term clinical course of patients undergoing percutaneous coronary intervention (PCI). Background: Chronic kidney disease (CKD) has been significantly associated with an increased in-hospital and 1-year mortality following PCI. Methods: In this single-centre retrospective study, glomerular filtration rate (GFR) at baseline was estimated in 371 patients not on dialysis, who underwent successful PCI between mid-1995 and mid-1999. Baseline demographic and angiographic characteristics, and long-term major adverse cardiac events and symptoms were compared for patients with GFR ≥60 ml/min/1.73 m2 (normal or mildly impaired renal function) and GFR ≥ 60 ml/ min/1.73 m2 (CKD). The independent effect of GFR, modelled both as a categorical and a continuous variable, on long-term clinical outcomes was also investigated using multivariate Cox regression analysis. Results: Nine-year all-cause and cardiac mortality rates were significantly higher in the CKD group (45.9% vs. 10.6%, P < 0.0001 and 35.4% vs. 7.1%, P < 0.0001 respectively), while there was no difference in the repeat revascularization (P = 0.27) and nonfatal Q-wave myocardial infarction (P = 0.74) rates. Multivariate analysis demonstrated an independent impact of the level of GFR on long-term mortality; adjusted 9-year all-cause and cardiac mortality increased by approximately 16% and 11%, respectively for a decrease of GFR from 120 to 60 ml/min/1.73 m2 and by approximately 14% and 9%, respectively for a decrease of GFR from 60 to 30 ml/min/1.73 m2. Conclusions: The level of renal function is a strong determinant of long-term all-cause and cardiac mortality after successful PCI. © 2006 Wiley-Liss, Inc.