Post-PCI acute heart failure is an independent predictor of long-term mortality in patients with chronic kidney disease

Background: This study aimed to clarify the association of post-percutaneous coronary intervention (PCI) acute heart failure (AHF) with all-cause long-term mortality in patients with chronic kidney disease (CKD).

Methods: In this prospective, observational study, 610 patients with CKD and coronary artery disease (CAD) undergoing PCI were included in the final analysis. Patients were divided to the non post-PCI AHF group (n = 557) and the post-PCI AHF group (n = 53). The diagnosis of post-PCI AHF was based on symptoms, prior cardiovascular history, and potential cardiac and noncardiac precipitants.

Results: The overall incidence of post-PCI AHF was 53/610 (8.7%). The incidence of all-cause long-term mortality was significantly higher in the post-PCI AHF group than in the non post-PCI AHF group (50.9% vs 23.2%, P < .01). The median follow-up period was 7.3 years (interquartile range: 3.7-8.4). After adjusting for left ventricular ejection fraction <40% at discharge, CKD stage, acute myocardial infarction, age and smoking, post-PCI AHF was the strongest predictor of all-cause long-term mortality (hazard ratio: 8.08; 95% CI: 3.04-21.48; P < .01).

Conclusions: In patients with CKD and CAD undergoing PCI, post-PCI AHF is the strongest predictor of all-cause long-term mortality.