Objective: To evaluate the safety of percutaneous coronary intervention (PCI) in patients with acute coronary syndromes (ACS) complicating chronic kidney disease (CKD).
Methods: We retrospectively evaluated the medical data of 335 patients hospitalized in our hospital with a diagnosis of ACS and CKD between 1 January 2011 and 30 May 2014. Patients were divided into two groups: PCI group who received PCI treatment during hospitalization (n = 135) and non-PCI group who did not receive PCI treatment (n = 200). Multivariable logistic regression analysis was performed to evaluate the connection between PCI and in-hospital death and acute renal insufficiency.
Results: The median GFR level of 335 patients was 36.26 (25.09-47.65) ml · min⁻¹ · 1.73 m⁻². GFR level was similar between the two groups (P = 0.205). Multivariable logistic regression analysis showed that PCI did not increase the risk of in-hospital death (OR = 0.465, 95% CI: 0.190-1.136, P = 0.093) and in-hospital acute renal insufficiency (OR = 0.830, 95% CI: 0.375-1.836, P = 0.669). In patients of 45 ml · min⁻¹ · 1.73 m⁻² ≤ GFR < 60 ml · min⁻¹ · 1.73 m⁻², 30 ml · min⁻¹ · 1.73 m⁻² ≤ GFR < 45 ml · min⁻¹ · 1.73 m⁻² and GFR < 30 ml · min⁻¹ · 1.73 m⁻², the OR of in-hospital death in PCI group were 0.235 (95% CI: 0.024-2.301, P = 0.213), 0.640 (95% CI: 0.112-3.649, P = 0.616) and 0.919 (95% CI: 0.159-5.307, P = 0.925), and the OR of in-hospital acute renal insufficiency were 0.436 (95% CI: 0.120-1.587, P = 0.208), 2.209 (95% CI: 0.394-12.391, P = 0.368) and 0.724 (95% CI: 0.127-4.117, P = 0.716) indicating that PCI did not increase above events in ACS patients complicating CKD.
Conclusion: PCI does not increase the risk of in-hospital death and in-hospital acute renal insufficiency in ACS patients complicating CKD.