Patients with continuous deterioration of kidney function (CDKF) following percutaneous coronary intervention (PCI) for acute coronary syndrome are at an increased risk of mortality, according to a Japanese study published online ahead of print in The American Journal of Cardiology.
Naohiko Nemoto, MD, PhD, of Toho University in Tokyo, and collaborators studied 531 patients who underwent PCI for acute coronary syndromes. They defined CDKF as a serum creatinine level increase of more than 25% or greater than 0.5 mg/dL above baseline after 6 to 8 months. Patients with CDKF had significantly higher 5-year mortality rates than patients without CDKF (25% vs. 9.4%). In addition to CDKF, independent risk factors for 5-year mortality were age older than 75 years, anemia, New York Heart Association class 4 or 5, and low ejection fraction.
The researchers noted that pre-procedural chronic kidney disease and contrast-induced acute kidney injury are predictors of in-hospital death and long-term mortality, but the time course of kidney function after PCI and the relation between the time course of kidney function and prognosis have not been studied.