Abstract
Background: The effect of #chronic kidney disease (CKD) on the
long-term prognosis of patients with #atrial fibrillation (AF) undergoing
coronary
stenting was less studied.
Methods: We enrolled 2,511 patients with nonvalvular AF undergoing coronary stenting between January 2010 and June 2015 from 12
hospitals in Beijing, China.
Results: 22.9% had CKD (creatinine clearance <60ml/min).
Compared to those with preserved renal function, patients with CKD were
older,
and had the higher prevalence of women, hypertension, previous ischemic
stroke, cardiac dysfunction, and anemia. All patients were treated with
drug-eluting stents. Dual #antiplatelet therapy was the dominant #antithrombotic strategy in both groups (96.0% vs. 93.9%, P=0.054). The
follow-up
duration was 39.5±18.6 months. Complete follow-up data was obtained for
95.3% of this cohort. CKD group had higher incidences of death (19.0%
vs. 6.9%, P<0.001), ischemic stroke (5.5% vs. 3.3%, P=0.020), MACCE
(a composite of all-cause death, non-fatal myocardial infarction, target
vessel
revascularization, ischemic stroke and arterial #thromboembolism, 28.2%
vs. 14.7%, P<0.001) and Bleeding Academic Research Consortium (BARC)
≥ grade 3 (2.4% vs. 0.8%, P=0.003). No significant difference was noted
with regard to myocardial infarction and target vessel
revascularization. Cox
multivariate regression identified CKD as an independent risk factor for
all-cause death (Hazard ratio [HR]: 1.85, 95%CI: 1.37-2.50), MACCE (HR:
1.56, 95%CI: 1.25-1.96) and BARC ≥3 bleeding (HR: 3.14, 95%CI:
1.49-6.61), but not for ischemic stroke (HR: 1.10, 95%CI: 0.67-1.79).
Conclusion: CKD was independently associated with poor long-term #prognosis except for ischemic stroke in patients with AF and coronary
stenting.
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