*Corresponding author:Yong Jian Wu, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, No. 167 Beilishi Road, Xicheng District, Beijing, People’s Republic of China 100037, China
Received: August 01, 2018; Published: August 10, 2018
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Background: The effect of chronic kidney disease (CKD) on the long-term prognosis of patients with atrial fibrillation (AF) undergoing coronary stenting was less studied.
Methods: We enrolled 2,511 patients with nonvalvular AF undergoing coronary stenting between January 2010 and June 2015 from 12 hospitals in Beijing, China.
Results: 22.9% had CKD (creatinine clearance <60ml/min). Compared to those with preserved renal function, patients with CKD were older, and had the higher prevalence of women, hypertension, previous ischemic stroke, cardiac dysfunction, and anemia. All patients were treated with drug-eluting stents. Dual antiplatelet therapy was the dominant antithrombotic strategy in both groups (96.0% vs. 93.9%, P=0.054). The follow-up duration was 39.5±18.6 months. Complete follow-up data was obtained for 95.3% of this cohort. CKD group had higher incidences of death (19.0% vs. 6.9%, P<0.001), ischemic stroke (5.5% vs. 3.3%, P=0.020), MACCE (a composite of all-cause death, non-fatal myocardial infarction, target vessel revascularization, ischemic stroke and arterial thromboembolism, 28.2% vs. 14.7%, P<0.001) and Bleeding Academic Research Consortium (BARC) ≥ grade 3 (2.4% vs. 0.8%, P=0.003). No significant difference was noted with regard to myocardial infarction and target vessel revascularization. Cox multivariate regression identified CKD as an independent risk factor for all-cause death (Hazard ratio [HR]: 1.85, 95%CI: 1.37-2.50), MACCE (HR: 1.56, 95%CI: 1.25-1.96) and BARC ≥3 bleeding (HR: 3.14, 95%CI: 1.49-6.61), but not for ischemic stroke (HR: 1.10, 95%CI: 0.67-1.79).
Conclusion: CKD was independently associated with poor long-term prognosis except for ischemic stroke in patients with AF and coronary stenting.
Keywords: Atrial Fibrillation; Percutaneous Coronary Intervention; Chronic Kidney Disease; Prognosis
Abbreviations: CKD: Chronic Kidney Disease; AF: Atrial Fibrillation; PCI: Percutaneous Coronary Intervention; MACCE: Major Adverse Cardiac/Cerebrovascular Events; BARC: Bleeding Academic Research Consortium; HR: Hazard Ratio