Kidney Stone History and Adverse Outcomes After Percutaneous Coronary Intervention

• Published in: Urology (Ridgewood, N.J.) N.J.), 2020-02, Vol.136, p.75-81
• Main Authors: Lai, Chao-Han, Huang, Li-Ching, Holby, S. Neil, Lai, Ying-Ju, Su, Pei-Fang, Cheng, Yu-Sheng, Shyr, Yu, Hsi, Ryan S.
• Format: Article
• Language: English
• Subjects: Aged; Female; Humans; Kidney Calculi - complications; Male; Middle Aged; Myocardial Infarction - etiology; Percutaneous Coronary Intervention - adverse effects; Postoperative Complications - etiology; Retrospective Studies
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2019.10.009

To determine whether kidney stone history is associated with adverse outcomes after percutaneous coronary intervention (PCI). Kidney stone formers have an increased risk of developing coronary artery disease; however, whether these patients have worse cardiac outcomes is unknown. We identified adult patients who underwent first-time PCI in Vanderbilt University Medical Center (VUMC) Synthetic Derivative from 2008 to 2016 (n = 11,289) and in a nationwide database of Taiwan (NHIRD) from 2005 to 2012 (n = 155,762). Odds ratios (ORs) of 30-day in-hospital mortality and hazard ratios (HRs) of 1-year and 3-year adverse outcomes associated with kidney stone history were estimated using a propensity score approach. Overall, 294 and 12,286 stone formers undergoing PCI were identified in the VUMC and NHIRD, respectively. After matching, stone formers at VUMC were at higher risks of 30-day in-hospital mortality (OR 2.79, 95% CI 1.15-6.69) and 1-year (HR 1.59, 95% CI 1.13-2.24) and 3-year (HR 1.36, 95% CI 1.02-1.81) myocardial infarction. In the NHIRD, kidney stone history was associated with 1-year (HR 1.12, 95% CI 1.03-1.21) and 3-year (HR 1.14, 95% CI 1.06-1.22) myocardial infarction. In a sensitivity analysis, stone formers undergoing kidney stone surgery were marginally associated with 30-day in-hospital mortality (OR 1.21, 95% CI 0.99-1.48) and were associated with 3-year myocardial infarction (HR 1.13, 95% CI 1.02-1.25). Kidney stone history is associated with poorer cardiac outcomes after PCI. Improving secondary cardiac prevention strategies after PCI may be necessary for patients with a history of kidney stone disease.