Outcomes following Percutaneous Coronary Intervention in Renal Transplant Recipients; A Binational collaborative analysis

Mamas; Rashid

Abstract

Objective: We sought to investigate the clinical and procedural characteristics in patients with a history of Renal Transplant (RT) and compare the outcomes with non-RT patients in two national cohorts of patients undergoing percutaneous coronary intervention (PCI).
Background: PCI in RT is challenging and complex with limited data around outcomes of RT compared to non-RT patients in the real world.
Methods: Data from the National Inpatient Sample (NIS) and British Cardiovascular Intervention Society (BCIS) were used to compare the clinical and procedural characteristics and outcomes of RT with non-RT patients undergoing PCI. The primary outcome of interest was in-hospital mortality.
Results: 0.2% in NIS and 0.3% in BCIS of PCI procedures between 2004-2014 and 2007-2014 were undertaken in patients with a history of RT. RT patients were younger, had a higher prevalence of congestive cardiac failure, hypertension, diabetes but similar use of drug eluting stent, intracoronary imaging and pressure wire studies compared to non-RT group. In the adjusted analysis, RT patients had increased odds of in-hospital mortality (NIS: OR 1.90 95%CI 1.41-2.57; BCIS: OR 1.60 95%CI 1.05-2.46) compared to patients without RT but no difference in vascular or bleeding events. Meta-analysis of the two datasets suggested an increase in in-hospital mortality (OR 1.79 95%CI 1.40-2.29) but no difference in vascular (OR 1.24 95%CI 0.77-2.00) or bleeding events (OR 1.21 95%CI 0.86-1.68).
Conclusion: This large collaborative analysis of two national database shows that patients with renal transplant are younger, more comorbid, and have increased mortality risk compared to general population undergoing PCI.

Citation

Mamas, & Rashid. (2021). Outcomes following Percutaneous Coronary Intervention in Renal Transplant Recipients; A Binational collaborative analysis. Mayo Clinic Proceedings, 363-376. https://doi.org/10.1016/j.mayocp.2020.04.045

• Acceptance Date: Apr 25, 2020
• Publication Date: Feb 1, 2021
• Journal: Mayo Clinic Proceedings
• Print ISSN: 0025-6196
• Publisher: Elsevier
• Pages: 363-376
• DOI: https://doi.org/10.1016/j.mayocp.2020.04.045
• Keywords: Renal transplant, mortality, percutaneous coronary intervention, complications
• Publisher URL: https://www.sciencedirect.com/science/article/abs/pii/S0025619620308302?via%3Dihub