Impact of chronic kidney disease on the incidence of peri-procedural myocardial injury in patients undergoing elective stent implantation

Soichiro Kumagai, Hideki Ishii, Tetsuya Amano, Tadayuki Uetani, Bunichi Kato, Ken Harada, Tomohiro Yoshida, Hirohiko Ando, Ayako Kunimura, Yusaku Shimbo, Katsuhide Kitagawa, Kazuhiro Harada, Mutsuharu Hayashi, Daiji Yoshikawa, Tatsuaki Matsubara, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1059-1063
Number of pages5
JournalNephrology Dialysis Transplantation
Volume27
Issue number3
DOIs
Publication statusPublished - 05-2012

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

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