Coronary artery diseaseRenal insufficiency is an independent predictor of mortality after percutaneous coronary intervention☆
Section snippets
Methods
The National Heart, Lung, and Blood Institute Dynamic Registry has been previously described6 and comprises patients who underwent PCI at 17 medical centers in the United States, Canada, and the Czech Republic during 2 waves of patient recruitment. There were no exclusion criteria, and initial and repeat interventional procedures were included. The first wave of enrollment was between July 1997 and February 1998 (n = 2,524 patients), and the second wave was between February and June 1999 (n =
Results
In total, 4,602 patients were enrolled and renal disease was present in 192 (4.2%; Table 1). Mean age for all patients was 62.8 years, and 64.2% were men. A random sampling of 71 patients with and 72 patients without renal disease revealed mean creatinine values of 3.3 ± 3.1 and 0.98 ± 0.25 mg/dl, respectively. This corresponded to mean creatinine clearances of 40.3 ± 28.4 and 96.2 ± 36.0 ml/min using the Cockroft-Gault formula. Patients with renal disease were more likely to be older, black,
Discussion
Whereas prior studies have evaluated the relative risk of renal disease on mortality compared with the relative risk conferred by other more established risk factors, the present study has shown that the risk imparted by renal disease is additive to other established risk factors of poor outcome (Table 4). In particular, over half of patients with renal disease presenting with acute MI either died or had another MI at 1 year (51.2% vs 11.7%, p <0.0001). This highly significant association was
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This study was funded in part by grant HL33292-14 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.