Percutaneous coronary intervention-associated nephropathy foreshadows increased risk of late adverse events in patients with normal baseline serum creatinine

Catheter Cardiovasc Interv. 2003 Jul;59(3):338-43. doi: 10.1002/ccd.10534.


In patients with chronic renal insufficiency, further decline in renal function (DRF) after percutaneous coronary intervention (PCI) is accompanied not only by adverse in-hospital events but also by increased risk of mortality and myocardial infarction at 1 year. This analysis was undertaken to determine if patients with normal renal function who develop DRF after PCI have a comparable increase in risk of death and myocardial infarction at 1 year, and whether this risk is independent of in-hospital complications (death, myocardial infarction, urgent coronary artery bypass grafting). We performed a retrospective analysis of all patients from a single center who underwent successful PCI with no major in-hospital complications who had pre-PCI serum creatinine (SCr) </= 1.2 mg/dl and no history of renal insufficiency. One-year follow-up was obtained by mail or telephone. There were 5,967 consecutive patients who met the inclusion criteria. Of these, 208 (3.5%) developed DRF (an increase in SCr >/= 50% of baseline). They were more likely to be older, female, non-Caucasian, diabetic and/or hypertensive. They reported more prior cerebral or peripheral vascular events. They had undergone more complex PCI and were exposed to more radiographic contrast than the 96.5% who did not develop DRF. After adjustment for baseline variables, DRF remained an independent predictor of 1-year mortality, myocardial infarction, and target vessel revascularization. In patients without prior renal impairment, DRF post-PCI is rare but is associated with an increased risk of late adverse cardiac events similar to that in chronic renal insufficiency patients.

Publication types

  • Comparative Study

MeSH terms

  • Acute Kidney Injury / epidemiology*
  • Acute Kidney Injury / etiology
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects*
  • Angioplasty, Balloon, Coronary / methods
  • Coronary Stenosis / diagnostic imaging
  • Coronary Stenosis / therapy*
  • Creatinine / analysis
  • Creatinine / blood*
  • Female
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / etiology
  • Kidney Function Tests
  • Logistic Models
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / etiology
  • Predictive Value of Tests
  • Prevalence
  • Probability
  • Radiography
  • Reference Values
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Sex Distribution
  • Survival Analysis
  • Time Factors


  • Creatinine