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Successful modeling of long term outcomes in end‐stage renal disease patients undergoing percutaneous coronary intervention with drug‐eluting stents
Author(s) -
Dunn Aaron N.,
Huded Chetan,
Raymond Russell,
Lincoff A. Michael,
Bajzer Christopher,
Kapadia Samir,
Ellis Stephen G.
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.29707
Subject(s) - medicine , mace , percutaneous coronary intervention , myocardial infarction , conventional pci , coronary artery disease , cardiology , end stage renal disease , hemodialysis
Abstract Objectives The objective of this study is to identify and model risk factors for major adverse cardiac events (MACE) and all‐cause mortality among patients with ESRD treated with PCI using DES. Background Patients with end‐stage renal disease (ESRD) have poor long‐term outcomes after percutaneous coronary intervention (PCI) compared with non‐ESRD patients. However, there is a paucity of literature regarding risk factors associated with outcomes of ESRD patients after PCI with drug‐eluding stents (DES). Methods This retrospective cohort study includes all patients with ESRD who underwent first‐time PCI with DES at a single, high‐volume hospital between 1/1/2005 and 12/31/2015, with follow‐up through 9/1/2019. Primary outcomes were MACE (cardiac death, myocardial infarction, or unplanned revascularization) and all‐cause mortality. Results Five‐year MACE was 83.0% and five‐year morality was 77.9% in patients with ESRD ( n = 285). Among ESRD patients, factors independently associated with MACE were C‐reactive peptide level, SYNTAX score, peripheral vascular occlusive disease, hemoglobin, and treatment of a restenotic lesion (c‐index = 0.66). Factors independently associated with mortality in ESRD patients were age, SYNTAX score, non‐use of statins at baseline, insulin‐dependent diabetes, chronic obstructive pulmonary disease (COPD), peripheral vascular occlusive disease, and platelet count (c‐index = 0.65). Conclusions Despite relatively poor 1‐and 5‐year outcomes among ESRD patients after PCI, risk of MACE and mortality among this cohort can be successfully modelled, which meaningfully informs clinicians regarding management of ESRD patients with coronary artery disease (CAD). Further investigations are necessary to determine whether or not outcomes might be improved through risk profile modification.