Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention

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dc.contributor.authorWong, N.
dc.contributor.authorDinh, D.T.
dc.contributor.authorBrennan, A.
dc.contributor.authorBatchelor, R.
dc.contributor.authorDuffy, S.J.
dc.contributor.authorShaw, J.A.
dc.contributor.authorChan, W.
dc.contributor.authorLayland, J.
dc.contributor.authorVan Gaal, W.J.
dc.contributor.authorReid, C.M.
dc.contributor.authorLiew, D.
dc.contributor.authorStub, D.
dc.date.issued2022
dc.descriptionFirst published October 11, 2022
dc.description.abstractBackground: Renal impairment post-percutaneous coronary intervention (post-PCI) is a well-described adverse effect following the administration of contrast media. Within a large cohort of registry patients, we aimed to explore the incidence, predictors and clinical outcomes of renal impairment post-PCI. Methods: The Victorian Cardiac Outcomes Registry is an Australian state-based clinical quality registry focusing on collecting data from all PCI capable centres. Data from 36 970 consecutive PCI cases performed between 2014 and 2018 were analysed. Patients were separated into three groups based on post-procedure creatinine levels (new renal impairment (NRI), defined as an absolute rise in serum creatinine>44.2 µmol/L or>25% of baseline creatinine; new renal impairment requiring dialysis (NDR), defined as worsening renal failure that necessitated a new requirement for renal dialysis; no NRI). Multivariate logistic regression analysis was performed to investigate the impact of NRI and NDR on clinical outcomes. Results: 3.1% (n=1134) of patients developed NRI, with an additional 0.6% (n=225) requiring dialysis. 96.3% (n=35 611) of patients did not develop NRI. Those who developed renal impairment were more comorbid, with higher rates of diabetes (22% vs 38% vs 38%, p<0.001), peripheral vascular disease (3.4% vs 8.2% vs 11%, p<0.001), chronic kidney disease (19% vs 49.7% vs 54.2%) and severe left ventricular dysfunction (5% vs 22% vs 40%, p<0.001). Multivariable analysis found that when compared with the no NRI group, those in the combined NRI/NDR group were at a greater risk of 30-day mortality (OR 4.77; 95% CI 3.89 to 5.86, p<0.001) and 30-day major adverse cardiac events (OR 3.72; 95% CI 3.15 to 4.39, p<0.001). Conclusions: NRI post-PCI remains a common occurrence, especially among comorbid patients, and is associated with a significantly increased morbidity and mortality risk.
dc.description.statementofresponsibilityNathan Wong, Diem T Dinh, Angela Brennan, Riley Batchelor, Stephen J Duffy, James A Shaw, William Chan, Jamie Layland, William J van Gaal, Christopher M Reid, Danny Liew, Dion Stub
dc.identifier.citationOpen Heart, 2022; 9(2):e001876-1-e001876-8
dc.identifier.doi10.1136/openhrt-2021-001876
dc.identifier.issn2398-595X
dc.identifier.issn2053-3624
dc.identifier.orcidLiew, D. [0000-0002-0131-623X] [0000-0003-2064-181X]
dc.identifier.urihttps://hdl.handle.net/2440/139430
dc.language.isoen
dc.publisherBMJ Publishing Group
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1111170
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/11136372
dc.rights© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
dc.source.urihttps://doi.org/10.1136/openhrt-2021-001876
dc.subjectPercutaneous coronary intervention
dc.subject.meshHumans
dc.subject.meshCreatinine
dc.subject.meshContrast Media
dc.subject.meshIncidence
dc.subject.meshHospital Mortality
dc.subject.meshRisk Factors
dc.subject.meshAustralia
dc.subject.meshRenal Insufficiency
dc.subject.meshPercutaneous Coronary Intervention
dc.titleIncidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention
dc.typeJournal article
pubs.publication-statusPublished

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