Comparison of Propensity Score-Matched Analysis of Acute Kidney Injury After Percutaneous Coronary Intervention With Transradial Versus Transfemoral Approaches.

MedStar author(s):
Citation: American Journal of Cardiology. 119(10):1507-1511, 2017 May 15PMID: 28341354Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleYear: 2017Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006MH - *Acute Kidney Injury/di [Diagnosis]MH - Acute Kidney Injury/ep [Epidemiology]MH - Acute Kidney Injury/et [Etiology]MH - AgedMH - *Catheterization, Peripheral/ae [Adverse Effects]MH - District of Columbia/ep [Epidemiology]MH - FemaleMH - Femoral ArteryMH - Follow-Up StudiesMH - HumansMH - IncidenceMH - MaleMH - Middle AgedMH - Myocardial Infarction/di [Diagnosis]MH - *Myocardial Infarction/su [Surgery]MH - Percutaneous Coronary Intervention/ae [Adverse Effects]MH - *Percutaneous Coronary Intervention/mt [Methods]MH - *Postoperative ComplicationsMH - *Propensity ScoreMH - Radial ArteryMH - RegistriesMH - Retrospective StudiesMH - Risk Assessment/mt [Methods]MH - Risk FactorsMH - Time FactorsISSN:
  • 0002-9149
Name of journal: The American journal of cardiologyAbstract: Copyright (c) 2017 Elsevier Inc. All rights reserved.Transradial percutaneous coronary intervention (TR-PCI) may be associated with reduced rates of acute kidney injury (AKI). There is limited data from real-world registries about AKI rates stratified by PCI access. Our aim was to evaluate AKI rates and correlates in TR-PCI versus transfemoral PCI (TF-PCI) in a propensity score-matched analysis of patient data from a large, single-center registry. We performed a 1:1 propensity score-matched analysis on consecutive patients who underwent PCI from January 2011 to June 2016, excluding those on dialysis. A multivariate logistic regression model was adjusted to variables found to be significant in univariate models. AKI was defined by creatinine increase of >0.3 mg/dL post-PCI during hospitalization. During the study period, 6,743 patients underwent PCI (TR-PCI n = 1,119). Initial univariate models revealed significant differences between patients with TF-PCI and TR-PCI. Contrast amount and procedure duration were both increased with TR-PCI versus TF-PCI (162 vs 154 ml, p = 0.003; and 86 vs 79 minutes, p <0.001, respectively). Multivariate propensity score analysis matched 536 pairs of patients. In this matched cohort, TR-PCI was associated with a reduced risk for AKI compared with TF-PCI in univariate (4.3% vs 10.4%, p <0.001) and multivariate adjusted models (odds ratio 0.28, 95% confidence interval 0.19 to 0.59, p <0.001).All authors: Alraies MC, Ben-Dor I, Buchanan K, Garcia-Garcia HM, Koifman E, Pichard AD, Rogers T, Satler LF, Steinvil A, Torguson R, Waksman RFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-05-06
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28341354 Available 28341354

Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006MH - *Acute Kidney Injury/di [Diagnosis]MH - Acute Kidney Injury/ep [Epidemiology]MH - Acute Kidney Injury/et [Etiology]MH - AgedMH - *Catheterization, Peripheral/ae [Adverse Effects]MH - District of Columbia/ep [Epidemiology]MH - FemaleMH - Femoral ArteryMH - Follow-Up StudiesMH - HumansMH - IncidenceMH - MaleMH - Middle AgedMH - Myocardial Infarction/di [Diagnosis]MH - *Myocardial Infarction/su [Surgery]MH - Percutaneous Coronary Intervention/ae [Adverse Effects]MH - *Percutaneous Coronary Intervention/mt [Methods]MH - *Postoperative ComplicationsMH - *Propensity ScoreMH - Radial ArteryMH - RegistriesMH - Retrospective StudiesMH - Risk Assessment/mt [Methods]MH - Risk FactorsMH - Time Factors

Copyright (c) 2017 Elsevier Inc. All rights reserved.

Transradial percutaneous coronary intervention (TR-PCI) may be associated with reduced rates of acute kidney injury (AKI). There is limited data from real-world registries about AKI rates stratified by PCI access. Our aim was to evaluate AKI rates and correlates in TR-PCI versus transfemoral PCI (TF-PCI) in a propensity score-matched analysis of patient data from a large, single-center registry. We performed a 1:1 propensity score-matched analysis on consecutive patients who underwent PCI from January 2011 to June 2016, excluding those on dialysis. A multivariate logistic regression model was adjusted to variables found to be significant in univariate models. AKI was defined by creatinine increase of >0.3 mg/dL post-PCI during hospitalization. During the study period, 6,743 patients underwent PCI (TR-PCI n = 1,119). Initial univariate models revealed significant differences between patients with TF-PCI and TR-PCI. Contrast amount and procedure duration were both increased with TR-PCI versus TF-PCI (162 vs 154 ml, p = 0.003; and 86 vs 79 minutes, p <0.001, respectively). Multivariate propensity score analysis matched 536 pairs of patients. In this matched cohort, TR-PCI was associated with a reduced risk for AKI compared with TF-PCI in univariate (4.3% vs 10.4%, p <0.001) and multivariate adjusted models (odds ratio 0.28, 95% confidence interval 0.19 to 0.59, p <0.001).

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