Author + information
- Arie Steinvil1,
- Gilbert Tang2,
- Hector Manel Garcia-Garcia3,
- Toby Rogers4,
- Sarkis Kiramijyan5,
- Edward Koifman3,
- Smita Negi6,
- Sang Yeub Lee7,
- Rebecca Torguson8,
- Augusto Pichard8,
- Lowell Satler8,
- Itshac Itsik Ben-dor8 and
- Ron Waksman9
- 1The Tel-Aviv Medical center, Tel-Aviv, Israel
- 2Westchester Medical Center
- 3MedStar Washington Hospital Center, Washington, District of Columbia, United States
- 4NIH, Bethesda, Maryland, United States
- 5MedStar Washington Hospital Center, Falls Church, Virginia, United States
- 6Washington Hospital Center, Wheaton, Maryland, United States
- 7MedStar Washington Hospital Center, North Bethesda, Maryland, United States
- 8Washington Hospital Center, Washington, District of Columbia, United States
- 9Medstar Heart Institute, Washington, District of Columbia, United States
Acute kidney injury (AKI) is a frequent complication following percutaneous coronary intervention (PCI). Recent data has shown reduced AKI rates with a trans-radial PCI (TR-PCI) versus trans-femoral PCI (TF-PCI). Our aim was to evaluate AKI rates and correlates in TR-PCI versus TF-PCI of a large single center registry.
We performed a 1:1 propensity score matched analysis on consecutive patients undergoing PCI in the period between Januarys 2011 to June 2016, excluding dialysis patients. A multivariate logistic regression model was adjusted to multiple variables found to be significantly significant in univariate models. AKI was defined by creatinine increase of ≥0.3mg/dl during hospitalization.
During the study period 6,740 underwent PCI (TR-PCI n=1117) . Initial Univariate models revealed significant differences between TF-PCI and TR-PCI patients including significantly lower rates of co-morbidities and critical state conditions for the later. Contrast amount and procedure length were both increased with TR-PCI vs. TF-PCI (162.54 vs. 154.84 ml, p=0.003; and 86.6 vs. 79 minutes,p <0.001, respectively). Multivariate propensity score analysis resulted in the matching of 536 pairs of patients. In this matched cohort, TR-PCI was significantly associated with a reduced risk for AKI as compared to TF-PCI in univariate (10.4% versus 4.3%, p<0.001, respectively) as well multivariate adjusted models (OR 0.28, 95%CI 0.19-0.59, p<0.001).
Significant differences exist between patients referred to TR-PCI and TF-PCI. Following propensity score matching however, TR-PCI was found to be significantly associated with reduced rates of AKI.
OTHER: Renal Insufficiency and Contrast Nephropathy