In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease

Peter Tajti, Aris Karatasakis, Barbara A. Danek, Khaldoon Alaswad, DImitri Karmpaliotis, Farouc A. Jaffer, James W. Choi, Robert W. Yeh, Mitul Patel, Ehtisham Mahmud, M. Nicholas Burke, Oleg Krestyaninov, Dmitrii Khelimskii, Catalin Toma, Anthony H. Doing, Barry Uretsky, Michalis Koutouzis, Ioannis Tsiafoutis, R. Michael Wyman, Santiago Garcia & 6 others Elizabeth Holper, Iosif Xenogiannis, Bavana Venkata Rangan, Subhash Banerjee, Imre Ungi, Emmanouil S Brilakis

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS: Compared with patients without CKD (n ≤ 1444; 73%), patients with CKD (n ≤ 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity. Patients with and without CKD had similar technical success rates (84% vs 86%; P≤.49) and procedural success rates (83% vs 84%; P≤.44). Patients with CKD had higher in-hospital mortality rate (1.9% vs 0.3%; P<.001) and in-hospital major adverse cardiovascular event (MACE) rate (4.3% vs 2.2%; P<.01). In-hospital mortality and MACE rates increased with decreasing eGFR levels (P≤.03). In multivariate analysis, an independent association was observed between CKD and in-hospital mortality (adjusted odd ratio, 4.4; 95% confidence interval, 1.2-16.0; P≤.02), but not overall MACE (adjusted odds ratio, 1.4; 95% confidence interval, 0.8-2.7; P≤.28). CONCLUSIONS: CKD is common among patients undergoing CTO-PCI. High success rates can be achieved in patients with decreased glomerular filtration rate, but CKD may be associated with higher in-hospital mortality.

Original languageEnglish (US)
Pages (from-to)E113-E121
JournalJournal of Invasive Cardiology
Volume30
Issue number11
StatePublished - Nov 1 2018

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Percutaneous Coronary Intervention
Chronic Renal Insufficiency
Hospital Mortality
Glomerular Filtration Rate
Odds Ratio
Confidence Intervals
Peripheral Arterial Disease
Coronary Artery Bypass
Comorbidity
Diabetes Mellitus
Multivariate Analysis
Heart Failure
Stroke
Myocardial Infarction
Hypertension
Transplants
Mortality

Keywords

  • Chronic kidney disease
  • Chronic total occlusion
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Tajti, P., Karatasakis, A., Danek, B. A., Alaswad, K., Karmpaliotis, DI., Jaffer, F. A., ... Brilakis, E. S. (2018). In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease. Journal of Invasive Cardiology, 30(11), E113-E121.

In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease. / Tajti, Peter; Karatasakis, Aris; Danek, Barbara A.; Alaswad, Khaldoon; Karmpaliotis, DImitri; Jaffer, Farouc A.; Choi, James W.; Yeh, Robert W.; Patel, Mitul; Mahmud, Ehtisham; Burke, M. Nicholas; Krestyaninov, Oleg; Khelimskii, Dmitrii; Toma, Catalin; Doing, Anthony H.; Uretsky, Barry; Koutouzis, Michalis; Tsiafoutis, Ioannis; Wyman, R. Michael; Garcia, Santiago; Holper, Elizabeth; Xenogiannis, Iosif; Rangan, Bavana Venkata; Banerjee, Subhash; Ungi, Imre; Brilakis, Emmanouil S.

In: Journal of Invasive Cardiology, Vol. 30, No. 11, 01.11.2018, p. E113-E121.

Research output: Contribution to journalArticle

Tajti, P, Karatasakis, A, Danek, BA, Alaswad, K, Karmpaliotis, DI, Jaffer, FA, Choi, JW, Yeh, RW, Patel, M, Mahmud, E, Burke, MN, Krestyaninov, O, Khelimskii, D, Toma, C, Doing, AH, Uretsky, B, Koutouzis, M, Tsiafoutis, I, Wyman, RM, Garcia, S, Holper, E, Xenogiannis, I, Rangan, BV, Banerjee, S, Ungi, I & Brilakis, ES 2018, 'In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease', Journal of Invasive Cardiology, vol. 30, no. 11, pp. E113-E121.
Tajti P, Karatasakis A, Danek BA, Alaswad K, Karmpaliotis DI, Jaffer FA et al. In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease. Journal of Invasive Cardiology. 2018 Nov 1;30(11):E113-E121.
Tajti, Peter ; Karatasakis, Aris ; Danek, Barbara A. ; Alaswad, Khaldoon ; Karmpaliotis, DImitri ; Jaffer, Farouc A. ; Choi, James W. ; Yeh, Robert W. ; Patel, Mitul ; Mahmud, Ehtisham ; Burke, M. Nicholas ; Krestyaninov, Oleg ; Khelimskii, Dmitrii ; Toma, Catalin ; Doing, Anthony H. ; Uretsky, Barry ; Koutouzis, Michalis ; Tsiafoutis, Ioannis ; Wyman, R. Michael ; Garcia, Santiago ; Holper, Elizabeth ; Xenogiannis, Iosif ; Rangan, Bavana Venkata ; Banerjee, Subhash ; Ungi, Imre ; Brilakis, Emmanouil S. / In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease. In: Journal of Invasive Cardiology. 2018 ; Vol. 30, No. 11. pp. E113-E121.
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abstract = "OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS: Compared with patients without CKD (n ≤ 1444; 73{\%}), patients with CKD (n ≤ 535; 27{\%}) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity. Patients with and without CKD had similar technical success rates (84{\%} vs 86{\%}; P≤.49) and procedural success rates (83{\%} vs 84{\%}; P≤.44). Patients with CKD had higher in-hospital mortality rate (1.9{\%} vs 0.3{\%}; P<.001) and in-hospital major adverse cardiovascular event (MACE) rate (4.3{\%} vs 2.2{\%}; P<.01). In-hospital mortality and MACE rates increased with decreasing eGFR levels (P≤.03). In multivariate analysis, an independent association was observed between CKD and in-hospital mortality (adjusted odd ratio, 4.4; 95{\%} confidence interval, 1.2-16.0; P≤.02), but not overall MACE (adjusted odds ratio, 1.4; 95{\%} confidence interval, 0.8-2.7; P≤.28). CONCLUSIONS: CKD is common among patients undergoing CTO-PCI. High success rates can be achieved in patients with decreased glomerular filtration rate, but CKD may be associated with higher in-hospital mortality.",
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author = "Peter Tajti and Aris Karatasakis and Danek, {Barbara A.} and Khaldoon Alaswad and DImitri Karmpaliotis and Jaffer, {Farouc A.} and Choi, {James W.} and Yeh, {Robert W.} and Mitul Patel and Ehtisham Mahmud and Burke, {M. Nicholas} and Oleg Krestyaninov and Dmitrii Khelimskii and Catalin Toma and Doing, {Anthony H.} and Barry Uretsky and Michalis Koutouzis and Ioannis Tsiafoutis and Wyman, {R. Michael} and Santiago Garcia and Elizabeth Holper and Iosif Xenogiannis and Rangan, {Bavana Venkata} and Subhash Banerjee and Imre Ungi and Brilakis, {Emmanouil S}",
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T1 - In-Hospital Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients with Chronic Kidney Disease

AU - Tajti, Peter

AU - Karatasakis, Aris

AU - Danek, Barbara A.

AU - Alaswad, Khaldoon

AU - Karmpaliotis, DImitri

AU - Jaffer, Farouc A.

AU - Choi, James W.

AU - Yeh, Robert W.

AU - Patel, Mitul

AU - Mahmud, Ehtisham

AU - Burke, M. Nicholas

AU - Krestyaninov, Oleg

AU - Khelimskii, Dmitrii

AU - Toma, Catalin

AU - Doing, Anthony H.

AU - Uretsky, Barry

AU - Koutouzis, Michalis

AU - Tsiafoutis, Ioannis

AU - Wyman, R. Michael

AU - Garcia, Santiago

AU - Holper, Elizabeth

AU - Xenogiannis, Iosif

AU - Rangan, Bavana Venkata

AU - Banerjee, Subhash

AU - Ungi, Imre

AU - Brilakis, Emmanouil S

PY - 2018/11/1

Y1 - 2018/11/1

N2 - OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS: Compared with patients without CKD (n ≤ 1444; 73%), patients with CKD (n ≤ 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity. Patients with and without CKD had similar technical success rates (84% vs 86%; P≤.49) and procedural success rates (83% vs 84%; P≤.44). Patients with CKD had higher in-hospital mortality rate (1.9% vs 0.3%; P<.001) and in-hospital major adverse cardiovascular event (MACE) rate (4.3% vs 2.2%; P<.01). In-hospital mortality and MACE rates increased with decreasing eGFR levels (P≤.03). In multivariate analysis, an independent association was observed between CKD and in-hospital mortality (adjusted odd ratio, 4.4; 95% confidence interval, 1.2-16.0; P≤.02), but not overall MACE (adjusted odds ratio, 1.4; 95% confidence interval, 0.8-2.7; P≤.28). CONCLUSIONS: CKD is common among patients undergoing CTO-PCI. High success rates can be achieved in patients with decreased glomerular filtration rate, but CKD may be associated with higher in-hospital mortality.

AB - OBJECTIVES: The effect of chronic kidney disease (CKD) on in-hospital outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We evaluated the prevalence of CKD and its impact on CTO-PCI outcomes in 1979 patients who underwent 2040 procedures between 2012 and 2017 at 18 centers. CKD was defined as preprocedural estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2. RESULTS: Compared with patients without CKD (n ≤ 1444; 73%), patients with CKD (n ≤ 535; 27%) had more comorbidities (hypertension, diabetes mellitus, heart failure, peripheral arterial disease, prior myocardial infarction, PCI, coronary artery bypass graft surgery, and stroke), and more severe calcification and proximal vessel tortuosity. Patients with and without CKD had similar technical success rates (84% vs 86%; P≤.49) and procedural success rates (83% vs 84%; P≤.44). Patients with CKD had higher in-hospital mortality rate (1.9% vs 0.3%; P<.001) and in-hospital major adverse cardiovascular event (MACE) rate (4.3% vs 2.2%; P<.01). In-hospital mortality and MACE rates increased with decreasing eGFR levels (P≤.03). In multivariate analysis, an independent association was observed between CKD and in-hospital mortality (adjusted odd ratio, 4.4; 95% confidence interval, 1.2-16.0; P≤.02), but not overall MACE (adjusted odds ratio, 1.4; 95% confidence interval, 0.8-2.7; P≤.28). CONCLUSIONS: CKD is common among patients undergoing CTO-PCI. High success rates can be achieved in patients with decreased glomerular filtration rate, but CKD may be associated with higher in-hospital mortality.

KW - Chronic kidney disease

KW - Chronic total occlusion

KW - Percutaneous coronary intervention

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