In-Hospital outcomes in acute coronary syndrome patients with concomitant severe chronic kidney disease undergoing percutaneous coronary intervention

  • Saadia Sattar Tabba Heart Institute
  • Naseer Ahmed
  • Zohaib Akhter
  • Saba Aijaz
  • Shakir Lakhani
  • Rehan Malik
  • Asad Pathan
Keywords: Acute coronary syndrome, Renal Insufficiency, Percutaneous Coronary Intervention

Abstract

Objective: To determine in-hospital mortality and major adverse cardiac events (MACE) in acute coronary syndrome (AMI) patients with underlying severe chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).

Methods: We conducted a retrospective cohort study from June’2013-December’2017 at Tabba Heart Institute, Karachi. Data was drawn from institutes’ database modeled after US National Cardiovascular data CathPCI registry. All AMI (STEMI: ST-elevation myocardial infarction and NSTEMI: non-ST-elevation myocardial infarction) patients undergoing PCI with creatinine clearance <30ml/min or ESRD on hemodialysis were included in the study.

Results: During 54 months study period, 160 severe CKD patients underwent PCI. Mean age was 62.9±12.2 years. Men were 61.9%, hypertensive (81.3%) and diabetic (63.8%). Excluding dialysis patients, Creatinine clearance was 21.1±6.6ml/min/1.73m2. STEMI were 46.9% and 61.9% were Killip I. Mean SYNTAX score was 16.6±7.3. MACE occurred in 32.5% patients, of which 6(11.5%) had new hemodialysis and mortality: 17.5% were deceased. MACE predictor were cardiogenic shock (OR: 2.81, 95%CI: 1.17-6.74) and prior heart failure (OR: 6.84, 95%CI: 1.39-33.74), Predictor of mortality was cardiogenic shock or cardiac arrest (OR: 7.90, 95%CI: 2.95-21.17).

Conclusion: Severe CKD patients undergoing PCI for AMI have drastically poor outcomes therefore individualization and patient-centric care management is mandatory.

How to cite this:
Sattar S, Ahmed N, Akhter Z, Aijaz S, Lakhani S, Malik R, et al. In-Hospital outcomes in acute coronary syndrome patients with concomitant severe chronic kidney disease undergoing percutaneous coronary intervention. Pak J Med Sci. 2019;35(2):291-297.  doi: https://doi.org/10.12669/pjms.35.2.276

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Author Biographies

Saadia Sattar, Tabba Heart Institute

Research Consultant, Department of Clinical Cardiology

Naseer Ahmed

Cardiology Fellow, Department of Cardiology

Zohaib Akhter

Research Consultant, Department of Clinical Cardiology

Saba Aijaz

Consultant Cardiologist, Department of Cardiology

Shakir Lakhani

Consultant Cardiologist, Department of Cardiology

Rehan Malik

Research Officer, Department of Clinical Cardiology

Asad Pathan

Consultant Cardiologist, Department of Cardiology

Published
2019-03-02
Section
Original Articles