Impact of Chronic Kidney Disease on Utilization of Coronary Angiography and Percutaneous Coronary Intervention, and Their Outcomes in Patients With Non-ST Elevation Myocardial Infarction

Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Coronary angiography (CAG) and percutaneous coronary intervention (PCI) are frequently performed in patients presenting with a non-ST elevation myocardial infarction (NSTEMI). Utilizing the National Inpatient Samp...

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Bibliographic Details
Published in:The American journal of cardiology 2018-12, Vol.122 (11), p.1830-1836
Main Authors: Murray, Jeff, Balmuri, Abilash, Saurav, Alok, Smer, Aiman, Alla, Venkata Mahesh
Format: Article
Language:English
Subjects:
Aged
Angiography
Angioplasty
Cardiovascular disease
Cardiovascular diseases
Codes
Comorbidity
Coronary Angiography - trends
Coronary artery
Coronary vessels
Female
Follow-Up Studies
Health risks
Heart attacks
Heart surgery
Hospital costs
Hospital Mortality - trends
Hospitalization
Humans
Intervention
Kidney diseases
Kidneys
Male
Medical imaging
Morbidity
Mortality
Myocardial infarction
Nebraska - epidemiology
Non-ST Elevated Myocardial Infarction - complications
Non-ST Elevated Myocardial Infarction - diagnosis
Non-ST Elevated Myocardial Infarction - surgery
Patients
Percutaneous Coronary Intervention - trends
Registries
Renal function
Renal Insufficiency, Chronic - complications
Renal Insufficiency, Chronic - mortality
Renal replacement therapy
Retrospective Studies
Risk analysis
Risk Assessment - methods
Risk Factors
Survival Rate - trends
Time Factors
Treatment Outcome
Trends
Trinucleotide repeats
Veins & arteries
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Summary:Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. Coronary angiography (CAG) and percutaneous coronary intervention (PCI) are frequently performed in patients presenting with a non-ST elevation myocardial infarction (NSTEMI). Utilizing the National Inpatient Sample database, we assessed the trends in utilization of CAG, PCI, and coronary artery bypass grafting in 3,654,586 admissions with NSTEMI from 2001 to 2012. The rates of CAG were 54%, 36.1%, and 45.9%, respectively, in patients with normal renal function, patients with CKD not on renal replacement therapy (RRT), and patients with CKD requiring RRT. The in-hospital mortality for patients with NSTEMI was significantly higher in patients with CKD—3.9% in patients without CKD, 6.9% in CKD patients not on RRT, and 8.6% in CKD patients needing RRT. In a propensity-matched cohort of 126,740 NSTEMI admissions, CKD was associated with increased in-hospital mortality (7.9% vs 5.3%, p
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2018.08.024