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Outcomes following percutaneous coronary intervention in renal transplant recipients: A binational collaborative analysis

Outcomes following percutaneous coronary intervention in renal transplant recipients: A binational collaborative analysis
Outcomes following percutaneous coronary intervention in renal transplant recipients: A binational collaborative analysis

Objective: To investigate the clinical and procedural characteristics in patients with a history of renal transplant (RT) and compare the outcomes with patients without RT in 2 national cohorts of patients undergoing percutaneous coronary intervention (PCI). Patients and 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 patients undergoing PCI who had RT with those who did not have RT. The primary outcome of interest was in-hospital mortality. Results: Of the PCI procedures performed in 2004-2014 (NIS) and 2007-2014 (BCIS), 12,529 of 6,601,526 (0.2%) and 1521 of 512,356 (0.3%), respectively, were undertaken in patients with a history of RT. Patients with RT were younger and had a higher prevalence of congestive cardiac failure, hypertension, and diabetes but similar use of drug-eluting stents, intracoronary imaging, and pressure wire studies compared with patients who did not have RT. In the adjusted analysis, patients with RT had increased odds of in-hospital mortality (NIS: odds ratio [OR], 1.90; 95% CI, 1.41-2.57; BCIS: OR, 1.60; 95% CI, 1.05-2.46) compared with patients who did not have RT but no difference in vascular or bleeding events. Meta-analysis of the 2 data sets 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 (OR, 1.21; 95% CI, 0.86-1.68) events. Conclusion: This large collaborative analysis of 2 national databases revealed that patients with RT undergoing PCI are younger, have more comorbidities, and have increased mortality risk compared with the general population undergoing PCI.

0025-6196
363-376
Rashid, Muhammad
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Nagaraja, Vinayak
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Shoaib, Ahmad
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Curzen, Nick
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Ludman, Peter F.
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Kapadia, Samir R.
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Palmer, Nick
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Elgendy, Islam Y.
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Kalra, Ankur
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Vachharajani, Tushar J.
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Anderson, H. Vernon
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Kwok, Chun Shing
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Mohamed, Mohamed
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Banning, Adrian P.
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Mamas, Mamas A.
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Rashid, Muhammad
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Nagaraja, Vinayak
fe8a6557-9710-489a-9658-0a1f8818b9c8
Shoaib, Ahmad
87d9fdcb-a5ce-4379-8280-3115040dc364
Curzen, Nick
70f3ea49-51b1-418f-8e56-8210aef1abf4
Ludman, Peter F.
ed96bc44-311b-4a55-88d9-ce83bab3e791
Kapadia, Samir R.
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Palmer, Nick
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Elgendy, Islam Y.
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Kalra, Ankur
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Vachharajani, Tushar J.
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Anderson, H. Vernon
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Kwok, Chun Shing
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Mohamed, Mohamed
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Banning, Adrian P.
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Mamas, Mamas A.
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Rashid, Muhammad, Nagaraja, Vinayak, Shoaib, Ahmad, Curzen, Nick, Ludman, Peter F., Kapadia, Samir R., Palmer, Nick, Elgendy, Islam Y., Kalra, Ankur, Vachharajani, Tushar J., Anderson, H. Vernon, Kwok, Chun Shing, Mohamed, Mohamed, Banning, Adrian P. and Mamas, Mamas A. (2021) Outcomes following percutaneous coronary intervention in renal transplant recipients: A binational collaborative analysis. Mayo Clinic Proceedings, 96 (2), 363-376. (doi:10.1016/j.mayocp.2020.04.045).

Record type: Article

Abstract

Objective: To investigate the clinical and procedural characteristics in patients with a history of renal transplant (RT) and compare the outcomes with patients without RT in 2 national cohorts of patients undergoing percutaneous coronary intervention (PCI). Patients and 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 patients undergoing PCI who had RT with those who did not have RT. The primary outcome of interest was in-hospital mortality. Results: Of the PCI procedures performed in 2004-2014 (NIS) and 2007-2014 (BCIS), 12,529 of 6,601,526 (0.2%) and 1521 of 512,356 (0.3%), respectively, were undertaken in patients with a history of RT. Patients with RT were younger and had a higher prevalence of congestive cardiac failure, hypertension, and diabetes but similar use of drug-eluting stents, intracoronary imaging, and pressure wire studies compared with patients who did not have RT. In the adjusted analysis, patients with RT had increased odds of in-hospital mortality (NIS: odds ratio [OR], 1.90; 95% CI, 1.41-2.57; BCIS: OR, 1.60; 95% CI, 1.05-2.46) compared with patients who did not have RT but no difference in vascular or bleeding events. Meta-analysis of the 2 data sets 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 (OR, 1.21; 95% CI, 0.86-1.68) events. Conclusion: This large collaborative analysis of 2 national databases revealed that patients with RT undergoing PCI are younger, have more comorbidities, and have increased mortality risk compared with the general population undergoing PCI.

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More information

e-pub ahead of print date: 25 December 2020
Published date: 1 February 2021
Additional Information: Funding Information: Potential Competing Interests: Dr Curzen has been a consultant for HeartFlow, Inc, and Haemonetics Corporation; has received grants/has grants pending from Boston Scientific Corporation, HeartFlow, Inc, and Beckmann Coulter, Inc (funds paid to his institution); has received payment for lectures/service on speakers bureaus from Boston Scientific Corporation, HeartFlow, Inc, and Abbott; and has received funds for travel/accommodations/meeting expenses from Edwards Lifesciences Corporation, Biosensors International Group, Ltd, HeartFlow, Inc, and Medtronic. Dr Kwok has been a member of the board for Biosensors International Group (funds paid to his institution for PhD tuition). Dr Banning reports grant support to his institution from Boston Scientific; speaker fees from Boston Scientific, Abbott Vascular, and Medtronic. Funding Information: The National Inpatient Sample (NIS) is one of the largest inpatient databases in the United States. It was established by the Healthcare Cost and Utilization Project and is supported by the Agency for Healthcare Research and Quality (AHRQ). The deidentified survey data come from over 1000 nonfederal hospitals sampled from 45 states and represent over 35 million discharges annually. 18 Publisher Copyright: © 2020 Mayo Foundation for Medical Education and Research Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

Identifiers

Local EPrints ID: 452167
URI: http://eprints.soton.ac.uk/id/eprint/452167
ISSN: 0025-6196
PURE UUID: b454babe-2c4d-4e43-b050-4e907e81b2c4
ORCID for Nick Curzen: ORCID iD orcid.org/0000-0001-9651-7829

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Date deposited: 26 Nov 2021 17:33
Last modified: 06 Jun 2024 01:43

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Contributors

Author: Muhammad Rashid
Author: Vinayak Nagaraja
Author: Ahmad Shoaib
Author: Nick Curzen ORCID iD
Author: Peter F. Ludman
Author: Samir R. Kapadia
Author: Nick Palmer
Author: Islam Y. Elgendy
Author: Ankur Kalra
Author: Tushar J. Vachharajani
Author: H. Vernon Anderson
Author: Chun Shing Kwok
Author: Mohamed Mohamed
Author: Adrian P. Banning
Author: Mamas A. Mamas

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