Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention
Background Renal impairment post-percutaneous coronary intervention (post-PCI) is a well-described adverse effect following the administration of contrast media. Within a large cohort of registry patients, we aimed to explore the incidence, predictors and clinical outcomes of renal impairment post-P...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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2022
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93087 |
| _version_ | 1848765693756964864 |
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| author | Wong, N. Dinh, D.T. Brennan, A. Batchelor, R. Duffy, S.J. Shaw, J.A. Chan, W. Layland, J. Van Gaal, W.J. Reid, Christopher Liew, D. Stub, D. |
| author_facet | Wong, N. Dinh, D.T. Brennan, A. Batchelor, R. Duffy, S.J. Shaw, J.A. Chan, W. Layland, J. Van Gaal, W.J. Reid, Christopher Liew, D. Stub, D. |
| author_sort | Wong, N. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background Renal impairment post-percutaneous coronary intervention (post-PCI) is a well-described adverse effect following the administration of contrast media. Within a large cohort of registry patients, we aimed to explore the incidence, predictors and clinical outcomes of renal impairment post-PCI. Methods The Victorian Cardiac Outcomes Registry is an Australian state-based clinical quality registry focusing on collecting data from all PCI capable centres. Data from 36 970 consecutive PCI cases performed between 2014 and 2018 were analysed. Patients were separated into three groups based on post-procedure creatinine levels (new renal impairment (NRI), defined as an absolute rise in serum creatinine>44.2 μmol/L or>25% of baseline creatinine; new renal impairment requiring dialysis (NDR), defined as worsening renal failure that necessitated a new requirement for renal dialysis; no NRI). Multivariate logistic regression analysis was performed to investigate the impact of NRI and NDR on clinical outcomes. Results 3.1% (n=1134) of patients developed NRI, with an additional 0.6% (n=225) requiring dialysis. 96.3% (n=35 611) of patients did not develop NRI. Those who developed renal impairment were more comorbid, with higher rates of diabetes (22% vs 38% vs 38%, p<0.001), peripheral vascular disease (3.4% vs 8.2% vs 11%, p<0.001), chronic kidney disease (19% vs 49.7% vs 54.2%) and severe left ventricular dysfunction (5% vs 22% vs 40%, p<0.001). Multivariable analysis found that when compared with the no NRI group, those in the combined NRI/NDR group were at a greater risk of 30-day mortality (OR 4.77; 95% CI 3.89 to 5.86, p<0.001) and 30-day major adverse cardiac events (OR 3.72; 95% CI 3.15 to 4.39, p<0.001). Conclusions NRI post-PCI remains a common occurrence, especially among comorbid patients, and is associated with a significantly increased morbidity and mortality risk. |
| first_indexed | 2025-11-14T11:39:19Z |
| format | Journal Article |
| id | curtin-20.500.11937-93087 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | eng |
| last_indexed | 2025-11-14T11:39:19Z |
| publishDate | 2022 |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-930872023-09-18T04:56:33Z Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention Wong, N. Dinh, D.T. Brennan, A. Batchelor, R. Duffy, S.J. Shaw, J.A. Chan, W. Layland, J. Van Gaal, W.J. Reid, Christopher Liew, D. Stub, D. acute coronary syndrome heart failure, systolic myocardial infarction percutaneous coronary intervention Australia Contrast Media Creatinine Hospital Mortality Humans Incidence Percutaneous Coronary Intervention Renal Insufficiency Risk Factors Humans Creatinine Contrast Media Incidence Hospital Mortality Risk Factors Australia Renal Insufficiency Percutaneous Coronary Intervention Background Renal impairment post-percutaneous coronary intervention (post-PCI) is a well-described adverse effect following the administration of contrast media. Within a large cohort of registry patients, we aimed to explore the incidence, predictors and clinical outcomes of renal impairment post-PCI. Methods The Victorian Cardiac Outcomes Registry is an Australian state-based clinical quality registry focusing on collecting data from all PCI capable centres. Data from 36 970 consecutive PCI cases performed between 2014 and 2018 were analysed. Patients were separated into three groups based on post-procedure creatinine levels (new renal impairment (NRI), defined as an absolute rise in serum creatinine>44.2 μmol/L or>25% of baseline creatinine; new renal impairment requiring dialysis (NDR), defined as worsening renal failure that necessitated a new requirement for renal dialysis; no NRI). Multivariate logistic regression analysis was performed to investigate the impact of NRI and NDR on clinical outcomes. Results 3.1% (n=1134) of patients developed NRI, with an additional 0.6% (n=225) requiring dialysis. 96.3% (n=35 611) of patients did not develop NRI. Those who developed renal impairment were more comorbid, with higher rates of diabetes (22% vs 38% vs 38%, p<0.001), peripheral vascular disease (3.4% vs 8.2% vs 11%, p<0.001), chronic kidney disease (19% vs 49.7% vs 54.2%) and severe left ventricular dysfunction (5% vs 22% vs 40%, p<0.001). Multivariable analysis found that when compared with the no NRI group, those in the combined NRI/NDR group were at a greater risk of 30-day mortality (OR 4.77; 95% CI 3.89 to 5.86, p<0.001) and 30-day major adverse cardiac events (OR 3.72; 95% CI 3.15 to 4.39, p<0.001). Conclusions NRI post-PCI remains a common occurrence, especially among comorbid patients, and is associated with a significantly increased morbidity and mortality risk. 2022 Journal Article http://hdl.handle.net/20.500.11937/93087 10.1136/openhrt-2021-001876 eng http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1136372 http://creativecommons.org/licenses/by-nc/4.0/ fulltext |
| spellingShingle | acute coronary syndrome heart failure, systolic myocardial infarction percutaneous coronary intervention Australia Contrast Media Creatinine Hospital Mortality Humans Incidence Percutaneous Coronary Intervention Renal Insufficiency Risk Factors Humans Creatinine Contrast Media Incidence Hospital Mortality Risk Factors Australia Renal Insufficiency Percutaneous Coronary Intervention Wong, N. Dinh, D.T. Brennan, A. Batchelor, R. Duffy, S.J. Shaw, J.A. Chan, W. Layland, J. Van Gaal, W.J. Reid, Christopher Liew, D. Stub, D. Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| title | Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| title_full | Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| title_fullStr | Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| title_full_unstemmed | Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| title_short | Incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| title_sort | incidence, predictors and clinical implications of new renal impairment following percutaneous coronary intervention |
| topic | acute coronary syndrome heart failure, systolic myocardial infarction percutaneous coronary intervention Australia Contrast Media Creatinine Hospital Mortality Humans Incidence Percutaneous Coronary Intervention Renal Insufficiency Risk Factors Humans Creatinine Contrast Media Incidence Hospital Mortality Risk Factors Australia Renal Insufficiency Percutaneous Coronary Intervention |
| url | http://purl.org/au-research/grants/nhmrc/1111170 http://purl.org/au-research/grants/nhmrc/1111170 http://hdl.handle.net/20.500.11937/93087 |