Paper Information

Journal:   ARCHIVES OF IRANIAN MEDICINE   May 2019 , Volume 22 , Number 5; Page(s) 247 To 251.
 
Paper: 

Effect of Various Degrees of Chronic Kidney Disease on Long-term Outcome of Patients with Percutaneous Coronary Intervention

 
 
Author(s):  NOZARI YOUNES, SHAFIEE AKBAR, KASSAIAN SEYED EBRAHIM, JALALI ARASH, Roozbeh Mehrdad, Safarian Hadi*
 
* Tehran Heart Center, North Kargar Ave, Tehran, 1411713138, Tehran University of Medical Sciences, Tehran, Iran
 
Abstract: 
Background: We aimed to identify the association of degree of renal failure in chronic kidney disease patients who underwent percutaneous coronary intervention (PCI) at our center with 5-year major adverse cardiac events (MACE). Methods: In this cohort study, we enrolled all patients who underwent primary or elective PCI and completed their 5-year follow-up unless they developed events related to study end-points. Demographic, angiographic and clinical data of the participants were retrieved from our databank. Glomerular filtration rate (GFR) was calculated based on the Cockcroft-Gault equation for men and women, separately. Accordingly, our patients were classified into three groups: GFR ≥ 60, GFR < 60 and ≥ 30 and GFR < 30 mL/min. Then, the demographic and clinical data, as well as the frequency of MACE and its elements, were compared between the study groups. Results: We included the data for 5, 510 patients. MACE occurred in 891 (16. 1%) of the patients. A total of 632 cases (16. 7%) occurred in patients with GFR > 60 while 224 cases (18. 8%) and 35 events (43. 7%) occurred in patients with 30 ≤ GFR < 60 and GFR < 30 mL/min, respectively. So, GFR < 30 mL/min was significant predictor for MACE (hazard ratio [HR] = 3. 74, 95% CI: 2. 64– 5. 28; P < 0. 001). The prediction effect of GFR < 30 remained significant after adjustment for the confounding variables (HR = 3. 43, 95% CI: 2. 38– 4. 94; P < 0. 001). Conclusion: GFR <30 mL/min was a strong predictor for 5-year MACE. Moreover, in patients with GFR > 30 mL/min, PCI is a more applicable approach.
 
Keyword(s): Chronic kidney disease,Glomerular filtration rate,Major adverse cardiac events,Percutaneous coronary intervention,Survival
 
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