OR06-2
Impact of acute kidney injury at ten years post percutaneous coronary intervention
Presenter
Vinayak Nagaraja, M.B.B.S., Mayo Clinic College of Medicine and Science, Rochester, MN
Vinayak Nagaraja, M.B.B.S.1, Bradley R Lewis, MS1 and Mandeep Singh, M.D.2, (1)Mayo Clinic College of Medicine and Science, Rochester, MN, (2)Mayo Clinic Health System Rochester, Rochester, MN
Background
Acute kidney injury post percutaneous coronary intervention (AKI-post PCI) is not an uncommon site and is associated with morbidity, and mortality. The most common risk factors for AKI-post PCI include advanced age, chronic kidney disease, contrast volume, history of congestive heart failure, and cardiogenic shock. There is a paucity of data in regard to long-term data for patients with AKI-post PCI and hence we report ten years follow up of patients who developed AKI after undergoing PCI at the Mayo Clinic.
The Mayo Clinic PCI registry includes demographic, clinical, procedural, and angiographic data on all patients undergoing PCI. AKI-post PCI was defined change in serum creatinine by ≥ 0.3 mg/dl or an increase >=1.5 the value at admission.(7) The exclusion criteria for this study were patients on renal replacement therapy before the procedure. Based on this we divided the data into two cohorts one with AKI-post PCI and the other who did not develop AKI. Continuous variables were presented as mean (SD) or median (IQR) and discrete variables were presented as frequency (percentage). We performed univariate and multivariable cause-specific Cox proportional hazards models were fit to examine the effect of AKI-post PCI on the outcome of interest.
Results
Out of 7,869 patients 699 (8.9%) developed AKI-post PCI and 71 (0.9%) patients needed haemodialysis. After multivariant analysis, AKI-post PCI was related with an amplified risk of MACE (hazard ratio (HR): 1.73; 95% confidence interval (CI): 1.55 – 1.93) (Table 1, Figure). AKI-post PCI was associated with over a twofold elevated risk of all-cause mortality with an adjusted HR of 2.13 (95% CI: 1.89 – 2.41) and the risk of cardiac mortality was nearly three times (adjusted HR: 2.85; 95% CI: 2.26 – 3.60). The rate of repeat revascularization was also found to have an elevated risk(adjusted HR: 1.32; 95% CI: 1.55 – 1.93) in the AKI-post PCI cohort.
Conclusions
The impact of AKI-post PCI is substantial and is associated poor outcomes even at ten years of follow up.