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Abstract: FR-PO1034

Survival of Patients with Percutaneous Coronary Intervention of Acute Coronary Syndrome in Left Main Coronary Artery Disease: The Role of Kidney Function

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Balevski, Igor, University Medical Centre Maribor, Maribor, Slovenia
  • Arva, Vigor, University Medical Centre Maribor, Maribor, Slovenia
  • Burja, Sandra, Faculty of Medicine, University of Maribor, Maribor, Slovenia
  • Petreski, Tadej, University Medical Centre Maribor, Maribor, Slovenia
  • Piko, Nejc, University Clinical Centre Maribor, Maribor, Slovenia
  • Kanic, Vojko, University Medical Centre Maribor, Maribor, Slovenia
  • Bevc, Sebastjan, UKC Maribor, Maribor, Slovenia
Background

Chronic kidney disease (CKD) is associated with a high burden of stable coronary artery disease and an increased incidence of acute coronary syndromes (ACS). Left-main coronary artery disease (LMCAD) is the highest-risk lesion of ischemic heart disease, where revascularization with either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is needed. Presence of CKD may increase the risk of complications and mortality connected with revascularization procedures.
The aim of our study was to determine the role of CKD in the survival of patients after undergoing PCI for ACS in LMCAD.

Methods

In our retrospective study, 211 patients (142 male (67.3%)) were included. All patients underwent primary PCI because of LMCAD between January 1st, 2008 and December 31st, 2016. The patients were observed from PCI until their death or December 20st, 2018 (average time of observation was 5.3 years). Mean age of included patients was 69.2±11.3 years (minimum 38 years, maximum 91 years). CKD was defined as estimated glomerular filtration rate (eGFR)≤60 ml/min/1.73m2 by using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Comorbidities, such as arterial hypertension (AH), diabetes mellitus (DM), and dyslipidemia were recorded. Survival rates were analyzed using Kaplan-Meier survival curves. The Cox regression model was used to assess the influence of CKD, AH, DM and dyslipidemia.

Results

82.5% of patients had AH, 28% had DM and 64.4% had dyslipidemia. 24.2% of patients had eGFR≤60 ml/min/1.73 m2 (CKD group). Mean survival time of patients in the CKD group was 1294±1402 days and in the non-CKD group 2122±1246 days. 32 (62.73%) CKD and 53 (33.1%) non-CKD patients died. Kaplan-Meier survival analysis showed a higher risk of death for CKD patients (log-rank test; p<0.001). In Cox multivariable regression model, CKD remained a predictor of all-cause mortality in our patients (HR was 1.623 (95% CI 1.414-1.757; P=0.0001)). The impact of dyslipidemia on patient survival was statistically significant (p=0.0001), while AH (p=0.671) and DM (p=0.136) showed no impact on patient survival.

Conclusion

The results indicate an association between CKD and all-cause mortality in patients after undergoing PCI for ACS in LMCAD.