TY - JOUR
T1 - Impact of chronic kidney disease on the incidence of peri-procedural myocardial injury in patients undergoing elective stent implantation
AU - Kumagai, Soichiro
AU - Ishii, Hideki
AU - Amano, Tetsuya
AU - Uetani, Tadayuki
AU - Kato, Bunichi
AU - Harada, Ken
AU - Yoshida, Tomohiro
AU - Ando, Hirohiko
AU - Kunimura, Ayako
AU - Shimbo, Yusaku
AU - Kitagawa, Katsuhide
AU - Harada, Kazuhiro
AU - Hayashi, Mutsuharu
AU - Yoshikawa, Daiji
AU - Matsubara, Tatsuaki
AU - Murohara, Toyoaki
N1 - Funding Information:
Acknowledgements. This study was supported by a grant from the Aichi Kidney Foundation and a Grant-in-Aid for Scientific Research (KAKENHI) (No. 22790699) of the Japanese Ministry of Education, Culture, Sports, Science and Technology (MEXT) and Japanese Society for the Promotion of Science (JSPA).
PY - 2012/5
Y1 - 2012/5
N2 - Background. It is well known that chronic kidney disease is a strong independent predictor of adverse outcomes after percutaneous coronary intervention in patients with ischemic heart disease. Recently, peri-procedural myocardial injury has been associated with adverse cardiac events. The aim of this study was to investigate the relationship between renal function and peri-procedural myocardial injury in patients undergoing elective stent implantation. Methods. This study comprised 273 consecutive patients who underwent elective stent implantation. They were divided into two groups: estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and eGFR≥60 mL/min/1.73m2. Peri-procedural TnT levels higher than three times the normal limit were defined as peri-procedural myocardial injury. Results. Patients with eGFR <60 mL/min/1.73m2 showed a higher incidence of peri-procedural myocardial injury compared to patients with eGFR≥60 mL/min/1.73m2 (4.3 versus 20.9%, P < 0.0001). Even after a multivariate adjustment, the eGFR level predicted peri-procedural myocardial injury [odds ratio 0.92, 95% confidence interval (CI): 0.89-0.95, P < 0.0001]. Total stent length was also an independent predictor of peri-procedural myocardial injury (odds ratio 1.09, 95% CI: 1.02-1.16, P = 0.009). Using a receiver-operating curve analysis, eGFR level of 62.1 mL/ min/1.73m2 (sensitivity 93.3%, specificity 57.2%) was the best value (area under the curve = 0.803) to maximize the power of eGFR levels in predicting peri-procedural myocardial injury. Conclusions. Patients with eGFR <60 mL/min/1.73m2 were strongly associated with peri-procedural myocardial injury after elective stent implantation. Therefore, eGFR may be a simple and convenient predictor of periprocedural myocardial injury.
AB - Background. It is well known that chronic kidney disease is a strong independent predictor of adverse outcomes after percutaneous coronary intervention in patients with ischemic heart disease. Recently, peri-procedural myocardial injury has been associated with adverse cardiac events. The aim of this study was to investigate the relationship between renal function and peri-procedural myocardial injury in patients undergoing elective stent implantation. Methods. This study comprised 273 consecutive patients who underwent elective stent implantation. They were divided into two groups: estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2 and eGFR≥60 mL/min/1.73m2. Peri-procedural TnT levels higher than three times the normal limit were defined as peri-procedural myocardial injury. Results. Patients with eGFR <60 mL/min/1.73m2 showed a higher incidence of peri-procedural myocardial injury compared to patients with eGFR≥60 mL/min/1.73m2 (4.3 versus 20.9%, P < 0.0001). Even after a multivariate adjustment, the eGFR level predicted peri-procedural myocardial injury [odds ratio 0.92, 95% confidence interval (CI): 0.89-0.95, P < 0.0001]. Total stent length was also an independent predictor of peri-procedural myocardial injury (odds ratio 1.09, 95% CI: 1.02-1.16, P = 0.009). Using a receiver-operating curve analysis, eGFR level of 62.1 mL/ min/1.73m2 (sensitivity 93.3%, specificity 57.2%) was the best value (area under the curve = 0.803) to maximize the power of eGFR levels in predicting peri-procedural myocardial injury. Conclusions. Patients with eGFR <60 mL/min/1.73m2 were strongly associated with peri-procedural myocardial injury after elective stent implantation. Therefore, eGFR may be a simple and convenient predictor of periprocedural myocardial injury.
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U2 - 10.1093/ndt/gfr411
DO - 10.1093/ndt/gfr411
M3 - Article
C2 - 21771758
AN - SCOPUS:84861168560
SN - 0931-0509
VL - 27
SP - 1059
EP - 1063
JO - Nephrology Dialysis Transplantation
JF - Nephrology Dialysis Transplantation
IS - 3
ER -