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Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention

BACKGROUND: Chronic kidney disease (CKD) is very common in patients who are at a high risk of developing incident heart failure with reduced ejection fraction (HFrEF). However, the harmful effect of CKD on incident HFrEF has not yet been examined among patients with coronary artery disease (CAD) und...

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Autores principales: Lai, Wenguang, Zhao, Xiaoli, Yu, Sijia, Mai, Ziling, Zhou, Yang, Huang, Zhidong, Li, Qiang, Huang, Haozhang, Li, Huanqiang, Wei, Haiyan, Guo, Dachuan, Xie, Yun, Li, Shanggang, Lu, Hongyu, Liu, Jin, Chen, Shiqun, Liu, Yong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010558/
https://www.ncbi.nlm.nih.gov/pubmed/35433884
http://dx.doi.org/10.3389/fcvm.2022.856602
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author Lai, Wenguang
Zhao, Xiaoli
Yu, Sijia
Mai, Ziling
Zhou, Yang
Huang, Zhidong
Li, Qiang
Huang, Haozhang
Li, Huanqiang
Wei, Haiyan
Guo, Dachuan
Xie, Yun
Li, Shanggang
Lu, Hongyu
Liu, Jin
Chen, Shiqun
Liu, Yong
author_facet Lai, Wenguang
Zhao, Xiaoli
Yu, Sijia
Mai, Ziling
Zhou, Yang
Huang, Zhidong
Li, Qiang
Huang, Haozhang
Li, Huanqiang
Wei, Haiyan
Guo, Dachuan
Xie, Yun
Li, Shanggang
Lu, Hongyu
Liu, Jin
Chen, Shiqun
Liu, Yong
author_sort Lai, Wenguang
collection PubMed
description BACKGROUND: Chronic kidney disease (CKD) is very common in patients who are at a high risk of developing incident heart failure with reduced ejection fraction (HFrEF). However, the harmful effect of CKD on incident HFrEF has not yet been examined among patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). METHODS: Patients undergoing PCI with baseline left ventricular ejection fraction (LVEF) ≥ 40% were included from January 2007 to December 2018 (ClinicalTrials.gov NCT04407936). We defined incident HFrEF as a follow-up LVEF of <40% within 3–12 months after discharge. Multivariable logistical regression was performed to examine the association of CKD with incident HFrEF. RESULTS: Overall, of 2,356 patients (mean age 62.4 ± 10.7 years, 22.2% women), 435 (18.5%) had CKD, and 83 (3.5%) developed incident HFrEF following PCI. The rate of incident HFrEF in the CKD group was higher than that in the non-CKD group (6.9 vs. 2.8%; p < 0.001). Multivariate logistic regression analysis indicated that CKD was an independent risk factor of incident HFrEF [adjusted odds ratio (aOR) = 1.75; 95% CI, 1.03–2.92; p = 0.035] after adjustment for confounders including age, gender, diabetes, hypertension, atrial fibrillation, congestive heart failure (CHF), baseline LVEF, ACEI/ARB, and statins. Furthermore, patients with incident HFrEF have a higher ratio of all-cause mortality compared to those without HFrEF (26.5 vs. 8.1%; p < 0.001). CONCLUSIONS: Our results suggested that CKD was associated with increased risk of incident HFrEF, which was related to higher all-cause mortality in patients with CAD undergoing PCI. On this basis, more aggressive measures should be taken to prevent patients with CKD undergoing PCI from developing HFrEF.
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spelling pubmed-90105582022-04-16 Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention Lai, Wenguang Zhao, Xiaoli Yu, Sijia Mai, Ziling Zhou, Yang Huang, Zhidong Li, Qiang Huang, Haozhang Li, Huanqiang Wei, Haiyan Guo, Dachuan Xie, Yun Li, Shanggang Lu, Hongyu Liu, Jin Chen, Shiqun Liu, Yong Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: Chronic kidney disease (CKD) is very common in patients who are at a high risk of developing incident heart failure with reduced ejection fraction (HFrEF). However, the harmful effect of CKD on incident HFrEF has not yet been examined among patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI). METHODS: Patients undergoing PCI with baseline left ventricular ejection fraction (LVEF) ≥ 40% were included from January 2007 to December 2018 (ClinicalTrials.gov NCT04407936). We defined incident HFrEF as a follow-up LVEF of <40% within 3–12 months after discharge. Multivariable logistical regression was performed to examine the association of CKD with incident HFrEF. RESULTS: Overall, of 2,356 patients (mean age 62.4 ± 10.7 years, 22.2% women), 435 (18.5%) had CKD, and 83 (3.5%) developed incident HFrEF following PCI. The rate of incident HFrEF in the CKD group was higher than that in the non-CKD group (6.9 vs. 2.8%; p < 0.001). Multivariate logistic regression analysis indicated that CKD was an independent risk factor of incident HFrEF [adjusted odds ratio (aOR) = 1.75; 95% CI, 1.03–2.92; p = 0.035] after adjustment for confounders including age, gender, diabetes, hypertension, atrial fibrillation, congestive heart failure (CHF), baseline LVEF, ACEI/ARB, and statins. Furthermore, patients with incident HFrEF have a higher ratio of all-cause mortality compared to those without HFrEF (26.5 vs. 8.1%; p < 0.001). CONCLUSIONS: Our results suggested that CKD was associated with increased risk of incident HFrEF, which was related to higher all-cause mortality in patients with CAD undergoing PCI. On this basis, more aggressive measures should be taken to prevent patients with CKD undergoing PCI from developing HFrEF. Frontiers Media S.A. 2022-04-01 /pmc/articles/PMC9010558/ /pubmed/35433884 http://dx.doi.org/10.3389/fcvm.2022.856602 Text en Copyright © 2022 Lai, Zhao, Yu, Mai, Zhou, Huang, Li, Huang, Li, Wei, Guo, Xie, Li, Lu, Liu, Chen and Liu. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Lai, Wenguang
Zhao, Xiaoli
Yu, Sijia
Mai, Ziling
Zhou, Yang
Huang, Zhidong
Li, Qiang
Huang, Haozhang
Li, Huanqiang
Wei, Haiyan
Guo, Dachuan
Xie, Yun
Li, Shanggang
Lu, Hongyu
Liu, Jin
Chen, Shiqun
Liu, Yong
Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention
title Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention
title_full Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention
title_fullStr Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention
title_full_unstemmed Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention
title_short Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention
title_sort chronic kidney disease increases risk of incident hfref following percutaneous coronary intervention
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9010558/
https://www.ncbi.nlm.nih.gov/pubmed/35433884
http://dx.doi.org/10.3389/fcvm.2022.856602
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