Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention

Charanjit Rihal, Stephen C Textor, Diane E. Grill, Peter B. Berger, Henry H. Ting, Patricia Best, Mandeep Singh, Malcolm R. Bell, Gregory W. Barsness, Verghese Mathew, Kirk N. Garratt, David Holmes

Research output: Contribution to journalArticle

1228 Citations (Scopus)

Abstract

Background - In patients undergoing percutaneous coronary intervention (PCI) in the modern era, the incidence and prognostic implications of acute renal failure (ARF) are unknown. Methods and Results - With a retrospective analysis of the Mayo Clinic PCI registry, we determined the incidence of, risk factors for, and prognostic implications of ARF (defined as an increase in serum creatinine [Cr] >0.5 mg/dL from baseline) after PCI. Of 7586 patients, 254 (3.3%) experienced ARF. Among patients with baseline Cr <2.0, the risk of ARF was higher among diabetic than nondiabetic patients, whereas among those with a baseline Cr >2.0, all had a significant risk of ARF. In multivariate analysis, ARF was associated with baseline serum Cr, acute myocardial infarction, shock, and volume of contrast medium administered. Twenty-two percent of patients with ARF died during the index hospitalization compared with only 1.4% of patients without ARF (P<0.0001). After adjustment, ARF remained strongly associated with death. Among hospital survivors with ARF, 1- and 5-year estimated mortality rates were 12.1% and 44.6%, respectively, much greater than the 3.7% and 14.5% mortality rates in patients without ARF (P<0.0001). Conclusions - The overall incidence of ARF after PCI is low. Diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.0 are at high risk for ARF. ARF was highly correlated with death during the index hospitalization and after dismissal.

Original languageEnglish (US)
Pages (from-to)2259-2264
Number of pages6
JournalCirculation
Volume105
Issue number19
DOIs
StatePublished - May 14 2002

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Percutaneous Coronary Intervention
Acute Kidney Injury
Incidence
Creatinine
Hospitalization
Serum
Contrast Media
Registries
Shock
Multivariate Analysis
Myocardial Infarction

Keywords

  • Acute renal failure
  • Angioplasty
  • Coronary disease
  • Kidney
  • Stents

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. / Rihal, Charanjit; Textor, Stephen C; Grill, Diane E.; Berger, Peter B.; Ting, Henry H.; Best, Patricia; Singh, Mandeep; Bell, Malcolm R.; Barsness, Gregory W.; Mathew, Verghese; Garratt, Kirk N.; Holmes, David.

In: Circulation, Vol. 105, No. 19, 14.05.2002, p. 2259-2264.

Research output: Contribution to journalArticle

Rihal, C, Textor, SC, Grill, DE, Berger, PB, Ting, HH, Best, P, Singh, M, Bell, MR, Barsness, GW, Mathew, V, Garratt, KN & Holmes, D 2002, 'Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention', Circulation, vol. 105, no. 19, pp. 2259-2264. https://doi.org/10.1161/01.CIR.0000016043.87291.33
Rihal, Charanjit ; Textor, Stephen C ; Grill, Diane E. ; Berger, Peter B. ; Ting, Henry H. ; Best, Patricia ; Singh, Mandeep ; Bell, Malcolm R. ; Barsness, Gregory W. ; Mathew, Verghese ; Garratt, Kirk N. ; Holmes, David. / Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention. In: Circulation. 2002 ; Vol. 105, No. 19. pp. 2259-2264.
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abstract = "Background - In patients undergoing percutaneous coronary intervention (PCI) in the modern era, the incidence and prognostic implications of acute renal failure (ARF) are unknown. Methods and Results - With a retrospective analysis of the Mayo Clinic PCI registry, we determined the incidence of, risk factors for, and prognostic implications of ARF (defined as an increase in serum creatinine [Cr] >0.5 mg/dL from baseline) after PCI. Of 7586 patients, 254 (3.3{\%}) experienced ARF. Among patients with baseline Cr <2.0, the risk of ARF was higher among diabetic than nondiabetic patients, whereas among those with a baseline Cr >2.0, all had a significant risk of ARF. In multivariate analysis, ARF was associated with baseline serum Cr, acute myocardial infarction, shock, and volume of contrast medium administered. Twenty-two percent of patients with ARF died during the index hospitalization compared with only 1.4{\%} of patients without ARF (P<0.0001). After adjustment, ARF remained strongly associated with death. Among hospital survivors with ARF, 1- and 5-year estimated mortality rates were 12.1{\%} and 44.6{\%}, respectively, much greater than the 3.7{\%} and 14.5{\%} mortality rates in patients without ARF (P<0.0001). Conclusions - The overall incidence of ARF after PCI is low. Diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.0 are at high risk for ARF. ARF was highly correlated with death during the index hospitalization and after dismissal.",
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T1 - Incidence and prognostic importance of acute renal failure after percutaneous coronary intervention

AU - Rihal, Charanjit

AU - Textor, Stephen C

AU - Grill, Diane E.

AU - Berger, Peter B.

AU - Ting, Henry H.

AU - Best, Patricia

AU - Singh, Mandeep

AU - Bell, Malcolm R.

AU - Barsness, Gregory W.

AU - Mathew, Verghese

AU - Garratt, Kirk N.

AU - Holmes, David

PY - 2002/5/14

Y1 - 2002/5/14

N2 - Background - In patients undergoing percutaneous coronary intervention (PCI) in the modern era, the incidence and prognostic implications of acute renal failure (ARF) are unknown. Methods and Results - With a retrospective analysis of the Mayo Clinic PCI registry, we determined the incidence of, risk factors for, and prognostic implications of ARF (defined as an increase in serum creatinine [Cr] >0.5 mg/dL from baseline) after PCI. Of 7586 patients, 254 (3.3%) experienced ARF. Among patients with baseline Cr <2.0, the risk of ARF was higher among diabetic than nondiabetic patients, whereas among those with a baseline Cr >2.0, all had a significant risk of ARF. In multivariate analysis, ARF was associated with baseline serum Cr, acute myocardial infarction, shock, and volume of contrast medium administered. Twenty-two percent of patients with ARF died during the index hospitalization compared with only 1.4% of patients without ARF (P<0.0001). After adjustment, ARF remained strongly associated with death. Among hospital survivors with ARF, 1- and 5-year estimated mortality rates were 12.1% and 44.6%, respectively, much greater than the 3.7% and 14.5% mortality rates in patients without ARF (P<0.0001). Conclusions - The overall incidence of ARF after PCI is low. Diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.0 are at high risk for ARF. ARF was highly correlated with death during the index hospitalization and after dismissal.

AB - Background - In patients undergoing percutaneous coronary intervention (PCI) in the modern era, the incidence and prognostic implications of acute renal failure (ARF) are unknown. Methods and Results - With a retrospective analysis of the Mayo Clinic PCI registry, we determined the incidence of, risk factors for, and prognostic implications of ARF (defined as an increase in serum creatinine [Cr] >0.5 mg/dL from baseline) after PCI. Of 7586 patients, 254 (3.3%) experienced ARF. Among patients with baseline Cr <2.0, the risk of ARF was higher among diabetic than nondiabetic patients, whereas among those with a baseline Cr >2.0, all had a significant risk of ARF. In multivariate analysis, ARF was associated with baseline serum Cr, acute myocardial infarction, shock, and volume of contrast medium administered. Twenty-two percent of patients with ARF died during the index hospitalization compared with only 1.4% of patients without ARF (P<0.0001). After adjustment, ARF remained strongly associated with death. Among hospital survivors with ARF, 1- and 5-year estimated mortality rates were 12.1% and 44.6%, respectively, much greater than the 3.7% and 14.5% mortality rates in patients without ARF (P<0.0001). Conclusions - The overall incidence of ARF after PCI is low. Diabetic patients with baseline Cr values <2.0 mg/dL are at higher risk than nondiabetic patients, whereas all patients with a serum Cr >2.0 are at high risk for ARF. ARF was highly correlated with death during the index hospitalization and after dismissal.

KW - Acute renal failure

KW - Angioplasty

KW - Coronary disease

KW - Kidney

KW - Stents

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