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Impact of renal function on the immediate and long-term outcomes of percutaneous recanalization of coronary chronic total occlusions: A systematic review and meta-analysis.

Abstract：

BACKGROUND:Renal impairment is associated with worse in-hospital and long-term outcomes after coronary artery revascularization, yet limited evidence is available on its impact on short- and long-term outcomes after chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS:We conducted a systematic review of the literature and subsequent random-effect meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement to evaluate the effect of chronic kidney disease (CKD), defined as estimated glomerular filtration rate < 60 ml/min/1.73 m2, on CTO PCI. The outcomes of this study were in-hospital death, procedural failure, contrast-induced acute kidney injury and all-cause death at follow-up. RESULTS:Eight studies, with a total of 8439 patients (of whom 2256 had CKD) were included in the analysis. CKD was associated with higher technical (relative risk [RR] = 1.44, 95% confidence interval [CI] 1.14-1.82, p = .002) and procedural (risk ratio-RR = 1.40, 95% CI 1.00-1.96, p = .05) failure, higher in-hospital mortality (RR = 4.96, 95% CI 2.49-9.87 p < .001), bleeding complications (RR = 3.43, 95% CI 1.80-6.52, p < .001) and contrast-induced acute kidney injury (RR = 2.75, 95% CI 1.16-6.51, p = .001). CKD was also associated with higher all-cause mortality during long-term follow-up (RR = 3.56, 95% CI 1.08-5.99, p < .001). CONCLUSION:Compared with patients with normal renal function, CKD is associated with lower success and higher risk of acute and long-term complications after CTO PCI. Kidney function should be considered during decision-making on CTO recanalization.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Moroni F,Spangaro A,Carlino M,Baber U,Brilakis ES,Azzalini L

doi

10.1016/j.ijcard.2020.05.067

subject

Has Abstract

pub_date

2020-10-15 00:00:00

pages

200-206

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(20)32041-6

journal_volume

317

pub_type

杂志文章

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Impact of renal function on the immediate and long-term outcomes of percutaneous recanalization of coronary chronic total occlusions: A systematic review and meta-analysis.