Author + information
- Suchith Vuppala1,
- Haekyung Jeon-Slaughter1,
- Jerrold Grodin2,
- Shuaib M. Abdullah2,
- Houman Khalili2,
- Emmanouil Brilakis1 and
- Subhash Banerjee1
Chronic Kidney Disease (CKD) prevalence rate among veterans has risen in the past decade. The CKD associations with long term mortality and cardiovascular adverse event risks after stented PCI are unknown among veterans population.
This study extracted data from VA national Corporate Data Warehouse (CDW) veterans who received stented PCI at Veterans Administration Hospital System between January 01 2005 and December 31, 2010 (n=78,706). This study excluded patients without ACS (n=312), yielding a final sample size of 78,394. Kaplan-Meier curves and Cox models were used for time to event analysis and Hazard Ratios (HR) and 95% Confidence Intervals (CIs) were presented.
The mean follow up length of the study was 37 months. Of all, about 10% of patients (n=8,464) had CKD condition at the time of PCI. CKD patients compared to non CKD patients were significantly older (64.4±9.4 and 68.4±9.6, p<0.0001) and more likely to have other comorbid conditions (Diabetes 62.8% vs. 42.7%, p<0.0001; Hypertension 95.4% vs. 83.1%, p<0.0001; Hyperlipidemia 76.6% vs. 74.2%, p<0.0001). CKD patients were at increased risk of mortality and non-fatal MI or stroke than non CKD patients, but at a similar risk of repeated revascularization (HR 1.04, 95% CI 0.96-1.14, p=0.3175) at 5 years (Figure 1). After adjusting baseline characteristics, CKD patients were at increased risk of mortality (HR 1.97, 95% CI 1.87-2.08, p<0.0001) and non-fatal MI or stroke (HR 1.79, 95% CI 1.20-1.32, p<0.0001) than non CKD patients at 5 years.
CKD comorbidity doubled mortality risk of patients who underwent stented PCI procedure at 5 years. While CKD patients are at 1.7 fold increased risk of non-fatal myocardial Infarction (MI) and stroke at 5 years than non-CKD patients, but CKD was not associated with need for repeat revascularization in 5 years.