Prevalence and prognosis of percutaneous coronary intervention-associated nephropathy in patients with acute coronary syndrome and normal kidney function.

Abstract

INTRODUCTION AND OBJECTIVES:

The aim of this study was to analyze the prevalence, risk factors, and short- and long-term prognosis of patients with acute coronary syndrome and normal renal function who developed percutaneous coronary intervention-associated nephropathy.

METHODS:

This was an observational, retrospective, single-center study with a prospective follow-up of 470 consecutive patients hospitalized for acute coronary syndrome (not in cardiogenic shock) who underwent percutaneous coronary intervention, with no preexisting renal failure (admission creatinine ≤ 1.3mg/dL). Percutaneous coronary intervention-associated was defined as an increase in baseline creatinine ≥ 0.5 mg/dL or ≥ 25% baseline. The mean follow-up was 26.7 (14) months.

RESULTS:

Of the 470 patients, 30 (6.4%) developed percutaneous coronary intervention-associated nepfhropathy. The independent predictors for acute renal failure were admission hemoglobin level (odds ratio = 0.71) and maximum troponin I level prior to the procedure (odds ratio = 1.02). During the long-term follow-up, the patients whose renal function deteriorated had a higher incidence of total mortality (5 [16.7%] vs 27 [6.1%]; P = .027). In the Cox regression analysis, percutaneous coronary intervention-associated nepfhropathy was not an independent predictor for total mortality, but could be a predictor for cardiac mortality (hazard ratio=5.4; 95% confidence interval 1.35-21.3; P = .017).

CONCLUSIONS:

Percutaneous coronary intervention-associated nephropathy in patients with acute coronary syndrome and normal preexisting renal function is not uncommon and influences long-term survival.

• Authors: Lorenzo Hernando, Ester Canovas, Alfonso Freites, Adriana de la Rosa, Javier Alonso, Roberto del Castillo, Pablo Salinas, Gema Beatriz Montalvo, Ana Isabel Huelmos, Javier Botas
• Journal: Revista espanola de cardiologia (English ed.) (Rev Esp Cardiol (Engl Ed)) Vol. 68 Issue 4 Pg. 310-6 (Apr 2015) ISSN: 1885-5857 [Electronic] Spain
• PMID: 25263104 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Topics

• Acute Coronary Syndrome (diagnosis, surgery)
• Aged
• Female
• Follow-Up Studies
• Glomerular Filtration Rate (physiology)
• Humans
• Kidney Function Tests
• Male
• Odds Ratio
• Percutaneous Coronary Intervention (adverse effects)
• Prevalence
• Prognosis
• Renal Insufficiency, Chronic (epidemiology, etiology, physiopathology)
• Retrospective Studies
• Spain (epidemiology)
• Time Factors