151. Percutaneous coronary intervention for chronic total occlusion improved prognosis in patients with renal insufficiency at high risk of contrast-induced nephropathy
- Author
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Ping-Yan Chen, Yong Liu, Hualong Li, Yuanhui Liu, Shiqun Chen, Jiyan Chen, Ning Tan, Chong-Yang Duan, Wei Guo, and Yingling Zhou
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Contrast-induced nephropathy ,Renal function ,Contrast Media ,030204 cardiovascular system & hematology ,Coronary Angiography ,Article ,Nephropathy ,03 medical and health sciences ,0302 clinical medicine ,Percutaneous Coronary Intervention ,Risk Factors ,Internal medicine ,Medicine ,Humans ,030212 general & internal medicine ,Renal Insufficiency ,Aged ,Multidisciplinary ,business.industry ,Hazard ratio ,Percutaneous coronary intervention ,Odds ratio ,Middle Aged ,medicine.disease ,Prognosis ,Confidence interval ,Surgery ,surgical procedures, operative ,Coronary Occlusion ,Conventional PCI ,Cardiology ,Female ,business - Abstract
We investigated whether attempted percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) would improve the prognosis in patients with renal insufficiency at high risk of contrast-induced nephropathy (CIN). We analyzed 2,330 consecutive patients with renal insufficiency with or without CTOs who underwent coronary angiography or PCI from prospectively collected data. The long-term death and risk of CIN were evaluated among three groups: patients without CTOs (group A, n = 1,829), patients with un-attempted PCI for CTOs (group B, n = 142) and patients who underwent attempted PCI for CTOs (group C, n = 359). Overall, group B and group C (successful rate, 89%) patients had similar renal function and were not significantly associated with an increased risk of CIN (adjusted odds ratio [OR] = 0.88, 95% confidence interval [CI]: 0.41–1.93, P = 0.758). During a 2.33-year period (median), multivariate analysis demonstrated that attempted PCI for CTOs was independently associated with lower mortality (adjusted hazard ratio for death: 0.38, 95% CI: 0.18–0.83; P = 0.015). Attempted PCI for CTOs improved the long-term prognosis in patients with high-risk renal insufficiency and did not increase the risk of CIN.
- Published
- 2015