Renal failure after percutaneous coronary intervention is associated with high mortality

Abstract

Renal failure is a marker of poor outcome in the general population. Renal failure after percutaneous coronary artery intervention (PCI) is associated with an increased hazard of in‐hospital mortality. We hypothesized that post‐PCI renal insufficiency would be a predictor of long‐term mortality in patients undergoing PCI who survive for over 30 days after the procedure. A retrospective analysis was conducted from a registry of 9,067 patients undergoing PCI at our center from 1997 to 2001. A rise in creatinine by 1 mg/dl from baseline was defined as post‐PCI renal insufficiency. Vital status was assessed using Social Security Death Index. There were a total of 996 deaths over a mean follow‐up period of 3.2 years. In a multivariate analysis, history of recent acute myocardial infarction, older age, insulin‐dependent diabetes, baseline creatinine greater than 1.5 mg/dl, and presence of mitral regurgitation were associated with post‐PCI renal insufficiency. Developing post‐PCI renal insufficiency was associated with a 4.31‐fold hazard of mortality in univariate analysis and a 1.77‐fold hazard after adjustment for known predictors of mortality after PCI. The 1‐year survival in patients with renal failure was 70.3% ± 3.91%, compared to a survival of 93.6% ± 0.27% in those without any post‐PCI renal insufficiency (P < 0.0001). Acute renal insufficiency after PCI is a strong and independent predictor of long‐term mortality in patients who survived for 30 days after the procedure. Catheter Cardiovasc Interv 2005;64:442–448.