Patients who have a history of kidney stones are more likely to have adverse outcomes following percutaneous coronary intervention (PCI), new data suggest.

Chao-Han Lai, MD, PhD, of National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan, and colleagues identified adult patients undergoing first-time PCI at Vanderbilt University Medical Center (VUMC) in Nashville, Tennessee, and the National Health Insurance Research Database (NHIRD) in Taiwan. The VUMC and NHIRD cohorts included 11,289 and 155,762 patients, of whom 294 and 12,286 had a history of kidney stones, respectively.

The median follow-up periods were 2.5 years in the VUMC cohort and 3.7 years in the NHIRD cohort.

After matching patients by propensity score, stone formers at VUMC had nearly 2.8-fold increased odds of 30-day in-hospital mortality (the study’s primary outcome) and 1.6- and 1.4-fold increased risks of myocardial infarction (MI) at 1 and 3 years, respectively, according to a paper published online ahead of print in Urology. In the NHIRD group, kidney stone history was significantly associated with significant 12% and 14% increased risks of MI at 1 and 3 years.

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“We demonstrate that kidney stone patients undergoing PCI have increased risks of early and late adverse cardiac outcomes,” Dr Lai and colleagues concluded. “These findings suggest that kidney stone history may be a clinical indicator to risk-stratify patients undergoing PCI to better inform more aggressive secondary cardiac prevention measures. Our study adds to the growing body of literature linking kidney stone disease and coronary artery disease.”

The authors wrote that it “is plausible to speculate that kidney stone disease is a marker of the presence of more severe clinical or subclinical cardiovascular risk factors leading to poorer outcomes following PCI.”

Reference

Lai CH, Huang LC, Holby SN, et al. Kidney stone history and adverse outcomes after percutaneous coronary intervention, Urology (2019).

doi: https://doi.org/10.1016/j.urology.2019.10.009