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Longitudinal Risk of Adverse Events in Patients With Acute Kidney Injury After Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry.

Publication ,  Journal Article
Valle, JA; McCoy, LA; Maddox, TM; Rumsfeld, JS; Ho, PM; Casserly, IP; Nallamothu, BK; Roe, MT; Tsai, TT; Messenger, JC
Published in: Circ Cardiovasc Interv
April 2017

BACKGROUND: Acute kidney injury (AKI) remains a common complication after percutaneous coronary intervention (PCI) and is associated with adverse in-hospital patient outcomes. The incidence of adverse events after hospital discharge in patients having post-PCI AKI is poorly defined, and the relationship between AKI and outcomes after hospital discharge remains understudied. METHODS AND RESULTS: Using the National Cardiovascular Data Registry CathPCI registry, we assessed the incidence of AKI among Medicare beneficiaries after PCI from 2004 to 2009 and subsequent post-discharge adverse events at 1 year. AKI was defined using Acute Kidney Injury Network (AKIN) criteria. Adverse events included death, myocardial infarction, bleeding, and recurrent kidney injury. Using Cox methods, we determined the relationship between in-hospital AKI and risk of post-discharge adverse events by AKIN stage. In a cohort of 453 475 elderly patients undergoing PCI, 39 850 developed AKI (8.8% overall; AKIN stage 1, 85.8%; AKIN 2/3, 14.2%). Compared with no AKI, in-hospital AKI was associated with higher post-discharge hazard of death, myocardial infarction, or bleeding (AKIN 1: hazard ratio [HR], 1.53; confidence interval [CI], 1.49-1.56 and AKIN 2/3: HR, 2.13; CI, 2.01-2.26), recurrent AKI (AKIN 1: HR, 1.70; CI, 1.64-1.76; AKIN 2/3: HR, 2.22; CI, 2.04-2.41), and AKI requiring dialysis (AKIN 1: HR, 2.59; CI, 2.29-2.92; AKIN 2/3: HR, 4.73; CI, 3.73-5.99). For each outcome, the highest incidence was within 30 days. CONCLUSIONS: Post-PCI AKI is associated with increased risk of death, myocardial infarction, bleeding, and recurrent renal injury after discharge. Post-PCI AKI should be recognized as a significant risk factor not only for in-hospital adverse events but also after hospital discharge.

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Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

April 2017

Volume

10

Issue

4

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Registries
  • Prospective Studies
  • Prognosis
  • Postoperative Complications
  • Percutaneous Coronary Intervention
  • Male
 

Citation

APA
Chicago
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MLA
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Valle, J. A., McCoy, L. A., Maddox, T. M., Rumsfeld, J. S., Ho, P. M., Casserly, I. P., … Messenger, J. C. (2017). Longitudinal Risk of Adverse Events in Patients With Acute Kidney Injury After Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry. Circ Cardiovasc Interv, 10(4). https://doi.org/10.1161/CIRCINTERVENTIONS.116.004439
Valle, Javier A., Lisa A. McCoy, Thomas M. Maddox, John S. Rumsfeld, P Michael Ho, Ivan P. Casserly, Brahmajee K. Nallamothu, Matthew T. Roe, Thomas T. Tsai, and John C. Messenger. “Longitudinal Risk of Adverse Events in Patients With Acute Kidney Injury After Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry.Circ Cardiovasc Interv 10, no. 4 (April 2017). https://doi.org/10.1161/CIRCINTERVENTIONS.116.004439.
Valle, Javier A., et al. “Longitudinal Risk of Adverse Events in Patients With Acute Kidney Injury After Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry.Circ Cardiovasc Interv, vol. 10, no. 4, Apr. 2017. Pubmed, doi:10.1161/CIRCINTERVENTIONS.116.004439.
Valle JA, McCoy LA, Maddox TM, Rumsfeld JS, Ho PM, Casserly IP, Nallamothu BK, Roe MT, Tsai TT, Messenger JC. Longitudinal Risk of Adverse Events in Patients With Acute Kidney Injury After Percutaneous Coronary Intervention: Insights From the National Cardiovascular Data Registry. Circ Cardiovasc Interv. 2017 Apr;10(4).

Published In

Circ Cardiovasc Interv

DOI

EISSN

1941-7632

Publication Date

April 2017

Volume

10

Issue

4

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Risk Factors
  • Registries
  • Prospective Studies
  • Prognosis
  • Postoperative Complications
  • Percutaneous Coronary Intervention
  • Male