Association of Chronic Renal Insufficiency With In-Hospital Outcomes After Percutaneous Coronary Intervention
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Author
Gupta, Tanush
Paul, Neha
Kolte, Dhaval
Harikrishnan, Prakash
Khera, Sahil
Aronow, Wilbert S
Mujib, Marjan
Palaniswamy, Chandrasekar
Sule, Sachin
Jain, Diwakar
Ahmed, Ali
Cooper, Howard A
Frishman, William H
Fonarow, Gregg C
Panza, Julio A
Note: Order does not necessarily reflect citation order of authors.
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https://doi.org/10.1161/JAHA.115.002069Metadata
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Gupta, T., N. Paul, D. Kolte, P. Harikrishnan, S. Khera, W. S. Aronow, M. Mujib, et al. 2015. “Association of Chronic Renal Insufficiency With In-Hospital Outcomes After Percutaneous Coronary Intervention.” Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 4 (6): e002069. doi:10.1161/JAHA.115.002069. http://dx.doi.org/10.1161/JAHA.115.002069.Abstract
Background: The association of chronic renal insufficiency with outcomes after percutaneous coronary intervention (PCI) in the current era of drug-eluting stents and modern antithrombotic therapy has not been well characterized. Methods and Results: We queried the 2007–2011 Nationwide Inpatient Sample databases to identify all patients aged ≥18 years who underwent PCI. Multivariable logistic regression was used to compare in-hospital outcomes among patients with chronic kidney disease (CKD), patients with end-stage renal disease (ESRD), and those without CKD or ESRD. Of 3 187 404 patients who underwent PCI, 89% had no CKD/ESRD; 8.6% had CKD; and 2.4% had ESRD. Compared to patients with no CKD/ESRD, patients with CKD and patients with ESRD had higher in-hospital mortality (1.4% versus 2.7% versus 4.4%, respectively; adjusted odds ratio for CKD 1.15, 95% CI 1.12 to 1.19, P<0.001; adjusted odds ratio for ESRD 2.29, 95% CI 2.19 to 2.40, P<0.001), higher incidence of postprocedure hemorrhage (3.5% versus 5.4% versus 6.0%, respectively; adjusted odds ratio for CKD 1.21, 95% CI 1.18 to 1.23, P<0.001; adjusted odds ratio for ESRD 1.27, 95% CI 1.23 to 1.32, P<0.001), longer average length of stay (2.9 days versus 5.0 days versus 6.4 days, respectively; P<0.001), and higher average total hospital charges ($60 526 versus $77 324 versus $97 102, respectively; P<0.001). Similar results were seen in subgroups of patients undergoing PCI for acute coronary syndrome or stable ischemic heart disease. Conclusions: In patients undergoing PCI, chronic renal insufficiency is associated with higher in-hospital mortality, higher postprocedure hemorrhage, longer average length of stay, and higher average hospital charges.Other Sources
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599544/pdf/Terms of Use
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