Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention

Wenguang Lai; Xiaoli Zhao; Sijia Yu; Ziling Mai; Yang Zhou; Zhidong Huang; Qiang Li; Haozhang Huang; Huanqiang Li; Haiyan Wei; Dachuan Guo; Yun Xie; Shanggang Li; Hongyu Lu; Jin Liu; Shiqun Chen; Yong Liu

doi:10.3389/fcvm.2022.856602

Chronic Kidney Disease Increases Risk of Incident HFrEF Following Percutaneous Coronary Intervention

Front Cardiovasc Med. 2022 Apr 1:9:856602. doi: 10.3389/fcvm.2022.856602. eCollection 2022.

Authors

Wenguang Lai^{1

2

3}, Xiaoli Zhao⁴, Sijia Yu^{2

3

5}, Ziling Mai^{1

2

3}, Yang Zhou^{2

3}, Zhidong Huang^{2

3}, Qiang Li^{2

3}, Haozhang Huang^{2

3

5}, Huanqiang Li^{2

3}, Haiyan Wei⁶, Dachuan Guo⁷, Yun Xie^{1

2

3}, Shanggang Li^{2

3}, Hongyu Lu^{2

3}, Jin Liu^{2

3}, Shiqun Chen^{2

3}, Yong Liu^{1

2

3}

Affiliations

¹ School of Biology and Biological Engineering, South China University of Technology, Guangzhou, China.
² Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
³ Department of Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzho, China.
⁴ Department of Cardiology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
⁵ The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
⁶ Department of Cardiology, The First People's Hospital of Kashgar Prefecture, Kashgar, China.
⁷ Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Abstract

Background: Chronic kidney disease (CKD) is very common in patients who are at a high risk of developing incident heart failure with reduced ejection fraction (HFrEF). However, the harmful effect of CKD on incident HFrEF has not yet been examined among patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI).

Methods: Patients undergoing PCI with baseline left ventricular ejection fraction (LVEF) ≥ 40% were included from January 2007 to December 2018 (ClinicalTrials.gov NCT04407936). We defined incident HFrEF as a follow-up LVEF of <40% within 3-12 months after discharge. Multivariable logistical regression was performed to examine the association of CKD with incident HFrEF.

Results: Overall, of 2,356 patients (mean age 62.4 ± 10.7 years, 22.2% women), 435 (18.5%) had CKD, and 83 (3.5%) developed incident HFrEF following PCI. The rate of incident HFrEF in the CKD group was higher than that in the non-CKD group (6.9 vs. 2.8%; p < 0.001). Multivariate logistic regression analysis indicated that CKD was an independent risk factor of incident HFrEF [adjusted odds ratio (aOR) = 1.75; 95% CI, 1.03-2.92; p = 0.035] after adjustment for confounders including age, gender, diabetes, hypertension, atrial fibrillation, congestive heart failure (CHF), baseline LVEF, ACEI/ARB, and statins. Furthermore, patients with incident HFrEF have a higher ratio of all-cause mortality compared to those without HFrEF (26.5 vs. 8.1%; p < 0.001).

Conclusions: Our results suggested that CKD was associated with increased risk of incident HFrEF, which was related to higher all-cause mortality in patients with CAD undergoing PCI. On this basis, more aggressive measures should be taken to prevent patients with CKD undergoing PCI from developing HFrEF.

Keywords: chronic kidney disease; coronary artery disease; heart failure with reduced ejection fraction; incidence; left ventricular ejection fraction; percutaneous coronary intervention.

Associated data

ClinicalTrials.gov/NCT04407936