Chronic Kidney Disease Predisposes to Acute Congestive Heart Failure, Cardiogenic Shock, and Mortality in Patients Undergoing Percutaneous Coronary Intervention

• Published in: The American journal of cardiology 2024-12, Vol.233, p.19-27
• Main Authors: Iyer, Meghana, Ziada, Khaled, Cho, Leslie, Tamis-Holland, Jacqueline, Khot, Umesh, Krishnaswamy, Amar, Puri, Rishi, Kapadia, Samir, Reed, Grant W.
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; cardiogenic shock; Cardiovascular disease; Cardiovascular diseases; chronic kidney disease; Congestive heart failure; Coronary Artery Disease - complications; Coronary Artery Disease - mortality; Coronary Artery Disease - surgery; Coronary vessels; Creatinine; Dialysis; Epidermal growth factor receptors; Female; Glomerular Filtration Rate; Heart attacks; Heart failure; Heart Failure - complications; Heart Failure - mortality; Hemodialysis; Hospital Mortality; Hospitals; Humans; Intervention; Ischemia; Kidney diseases; Male; Medical history; Medical imaging; Middle Aged; Mortality; Patients; Percutaneous Coronary Intervention; Peritoneal dialysis; Registries; Regression analysis; Renal failure; Renal Insufficiency, Chronic - complications; Renal Insufficiency, Chronic - epidemiology; Retrospective Studies; Risk Factors; Shock, Cardiogenic - etiology; Shock, Cardiogenic - mortality; Variables
• ISSN: 0002-9149; 1879-1913; 1879-1913
• DOI: 10.1016/j.amjcard.2024.09.025

•Baseline estimated glomerular filtration rate is a strong, independent predictor of acute heart failure events after percutaneous coronary intervention.•Chronic kidney disease stages 3a to 5 independently predict heart failure events and in-hospital mortality. The relations between degrees of chronic kidney disease (CKD) and congestive heart failure (CHF) events after percutaneous coronary intervention (PCI) are not well characterized. We sought to determine the relation between different stages of CKD and acute CHF events, including HF and cardiogenic shock (CS), and the impact of CKD stages on all-cause mortality after PCI. Patients who underwent PCI from 2009 to 2017 were identified from our institution's National Cardiovascular Disease Registry CathPCI Database. Patients were stratified by CKD stage 1 (estimated glomerular filtration rate [eGFR] ≥90 ml/min/1.73 m2), 2 (60 to 89), 3a (45 to 59), 3b (30 to 44), 4 (16 to 29), 5 (≤15), and current dialysis. The primary end point was composite HF events defined as acute HF or CS within 30 days after PCI, or in-hospital mortality, stratified by CKD and analyzed by multivariable regression after screening with univariate analysis (p