In-Hospital Outcomes for Patients With End-Stage Renal Disease and Acute Coronary Syndrome Treated With Percutaneous Coronary Intervention With Mechanical Circulatory Support
Journal of the Society for Cardiovascular Angiography & Interventions
In-hospital outcomes for percutaneous coronary interventions (PCI) and mechanical circulatory support (MCS) in patients with end-stage renal disease (ESRD) presented with the acute coronary syndrome (ACS) are unknown.
Using the NIS database, patients with ACS who received PCI and MCS, including those with ESRD, were included in the study. The odds ratio was calculated to compare in-hospital outcomes between patients with ESRD versus no ESRD.
We identified a total of 9,614,249 patients (9,343,527 without ESRD; 270,722 with ESRD). The patients with ESRD had increased diabetes, valvular abnormalities, heart failure, and electrolyte abnormalities. The odds of stroke (4.3% vs 2.7%, OR: 1.6; 95% CI 1.52-1.71), major bleeding (14.2% vs 12.7%, OR: 1.14; 95% CI 1.10-1.17), and in-hospital mortality (40.2% vs 21.6%, OR: 2.44; 95% CI 2.38-2.50), P<.0001 for all, were significantly higher in patients with ESRD compared to those without ESRD. The odds of vascular complications were also significantly decreased (2.3% vs 2.6%, OR: 0.90; 95% CI 0.83-0.97), P=.005.
Patients with ESRD who develop ACS treated with combined PCI and MCS experience significantly worse outcomes, including increased mortality and stroke.
Chalek A, Dandu C, Zghouzi M, Ullah W, Razvi P, Osman H, et al. [Oviedo C, Elmakshbr N, Alhusain R]. In-hospital outcomes for patients with end-stage renal disease and acute coronary syndrome treated with percutaneous coronary intervention with mechanical circulatory support. J Soc Cardiovasc Angiogr Interv. 2022 May-Jun;1(3 Suppl):100112. doi:10.1016/j.jscai.2022.100112.