Characteristics of coronary atherosclerotic heart disease with chronic renal insufficiency, incidence of perioperative acute renal injury after percutaneous coronary intervention and the long-term prognosis assessment
Shen Hua
Qin Zheng
Zhou Yujie
Liu Xiaoli
Abstract：Objective To investigate the clinical characteristics of patients with coronary atherosclerotic heart disease(CHD) complicated with chronic kidney disease(CKD),the occurrence of perioperative acute renal injury (AKI) after percutaneous coronary intervention (PCI) and the risk factors of long-term prognosis.Methods A total of 1 156 CHD with CKD patients who had PCI in Beijing Anzhen Hospital,Capital Medical University from January 2012 to December 2016 were retrospectively analyzed.According to the baseline level of estimated glomerular filtration rate (eGFR) on admission,the patients were divided into 4 groups:eGFR≥ 60-90ml/(min· 1.73 m2)(n =698),eGFR ≥ 30-＜ 60 ml/(min · 1.73 m2) (n =356),eGFR ≥ 15-＜ 30 ml/(min · 1.73 m2) (n =84),eGFR ＜ 15 mL/(min · 1.73 m2) (n =18).Demographic data,clinical characteristics,perioperative AKI and major adverse cardiovascular events (MACE) in 12 months after PC1 were analyzed.Results CHD patients with severe CKD(low eGFR) were associated with advanced age(P ＜0.001),hypertension(P =0.002) and hyperlipidemia(P ＜ 0.001).Incidence of AKI was 8.5％ (98/1 156).Incidence of MACE was 8.7％ (100/1 156).Multivariate logistic regression showed that baseline eGFR(odds ratio =0.979,P =0.002),hypertension (odds ratio =7.319,P ＜ 0.001) and left ventricular ejection fraction (odds ratio =0.854,P ＜0.001) were risk factors of AKI during perioperative period of PCI.Cox regression risk model showed that AKI(hazard ratio =11.955,P ＜ 0.001),baseline eGFR (hazard ratio =0.962,P ＜ 0.001),age (hazard ratio =1.040,P =0.003) and left ventricular ejection fraction(hazard ratio =0.958,P ＜ 0.001) were independent risk factors of 12-month MACE.Kaplan-Meier curve indicated that patients with perioperative AKI had poor prognosis;incidence of MACE in AKI patients was higher than that in non-AKI patients (P ＜ 0.001).Conclusions CHD patients with CKD have metabolism syndrome components of hypertension and hyperlipemia.Poor renal function,hypertension and low left ventricular ejection fraction may increase the risk of AKI.Patients with perioperative AKI after PCI have poor prognosis.
Keywords：Coronary atherosclerotic heart diseaseRenal insufficiencyPercutaneous coronary interventionPrognosis
Publication Date：2019-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 801-805 )