Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Brain Mapping Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2019 May 1;22(5):247-251.
We aimed to identify the association of degree of renal failure in chronic kidney disease patients who underwent percutaneous coronary intervention (PCI) at our center with 5-year major adverse cardiac events (MACE).
In this cohort study, we enrolled all patients who underwent primary or elective PCI and completed their 5-year followup unless they developed events related to study end-points. Demographic, angiographic and clinical data of the participants were retrieved from our databank. Glomerular filtration rate (GFR) was calculated based on the Cockcroft-Gault equation for men and women, separately. Accordingly, our patients were classified into three groups: GFR ≥ 60, GFR < 60 and ≥30 and GFR < 30 mL/ min. Then, the demographic and clinical data, as well as the frequency of MACE and its elements, were compared between the study groups.
We included the data for 5,510 patients. MACE occurred in 891 (16.1%) of the patients. A total of 632 cases (16.7%) occurred in patients with GFR > 60 while 224 cases (18.8%) and 35 events (43.7%) occurred in patients with 30 ≤ GFR < 60 and GFR < 30 mL/min, respectively. So, GFR < 30 mL/min was significant predictor for MACE (hazard ratio [HR] = 3.74, 95% CI: 2.64-5.28; P < 0.001). The prediction effect of GFR < 30 remained significant after adjustment for the confounding variables (HR = 3.43, 95% CI: 2.38-4.94; P < 0.001).
GFR <30 mL/min was a strong predictor for 5-year MACE. Moreover, in patients with GFR > 30 mL/min, PCI is a more applicable approach.
本研究旨在探讨我院行经皮冠状动脉介入治疗（PCI）的慢性肾脏病患者肾功能衰竭程度与 5 年主要不良心脏事件（MACE）的相关性。
本队列研究纳入了所有在我院行择期或急诊 PCI 并完成 5 年随访的患者，除非发生与研究终点相关的事件。从我们的数据库中检索参与者的人口统计学、血管造影和临床数据。肾小球滤过率（GFR）分别根据 Cockcroft-Gault 方程计算男性和女性的 GFR。因此，我们将患者分为三组：GFR≥60、GFR＜60 且≥30 和 GFR＜30 mL/min。然后，比较研究组之间的人口统计学和临床数据，以及 MACE 及其各元素的发生率。
我们纳入了 5510 例患者的数据。MACE 发生在 891 例（16.1%）患者中。GFR＞60 的患者中有 632 例（16.7%）发生 MACE，GFR 为 30≤GFR＜60 的患者中有 224 例（18.8%）和 35 例（43.7%）发生 MACE，GFR＜30 的患者中有 35 例（43.7%）发生 MACE。因此，GFR＜30 mL/min 是 MACE 的显著预测因素（危险比[HR] = 3.74，95%CI：2.64-5.28；P＜0.001）。在调整混杂因素后，GFR＜30 mL/min 的预测效果仍然显著（HR = 3.43，95%CI：2.38-4.94；P＜0.001）。
GFR＜30 mL/min 是 5 年 MACE 的强烈预测因素。此外，在 GFR＞30 mL/min 的患者中，PCI 是一种更适用的治疗方法。
