Association of chronic renal insufficiency with in-hospital outcomes after percutaneous coronary intervention

Background: the association of chronic renal insufficiency with outcomes after percutaneous coronary intervention (pci) in the current era of drug-eluting stents and modern antithrombotic therapy has not been well characterized.methods and results: we queried the 2007-2011 nationwide inpatient sample databases to identify all patients aged ≥18 years who underwent pci. multivariable logistic regression was used to compare in-hospital outcomes among patients with chronic kidney disease (ckd),patients with end-stage renal disease (esrd),and those without ckd or esrd. of 3 187 404 patients who underwent pci,89% had no ckd/esrd; 8.6% had ckd; and 2.4% had esrd. compared to patients with no ckd/esrd,patients with ckd and patients with esrd had higher in-hospital mortality (1.4% versus 2.7% versus 4.4%,respectively; adjusted odds ratio for ckd 1.15,95% ci 1.12 to 1.19,p<0.001; adjusted odds ratio for esrd 2.29,95% ci 2.19 to 2.40,p<0.001),higher incidence of postprocedure hemorrhage (3.5% versus 5.4% versus 6.0%,respectively; adjusted odds ratio for ckd 1.21,95% ci 1.18 to 1.23,p<0.001; adjusted odds ratio for esrd 1.27,95% ci 1.23 to 1.32,p<0.001),longer average length of stay (2.9 days versus 5.0 days versus 6.4 days,respectively; p<0.001),and higher average total hospital charges ($60 526 versus $77 324 versus $97 102,respectively; p<0.001). similar results were seen in subgroups of patients undergoing pci for acute coronary syndrome or stable ischemic heart disease.conclusions: in patients undergoing pci,chronic renal insufficiency is associated with higher in-hospital mortality,higher postprocedure hemorrhage,longer average length of stay,and higher average hospital charges. © 2015 the authors. published on behalf of the american heart association,inc.,by wiley blackwell.