Abstract 13711: End-Stage Renal Failure and Bleeding Complications in Patients Undergoing Percutaneous Coronary Intervention: A Contemporary System-Wide Analysis

Abstract

Background: Patients with chronic kidney disease (CKD) and significant impairment of kidney function (eGFR of 15-29 ml/min/1.73m 2 ) ( CKD Stage G4 ) and patients with an eGFR of <15 ml/min/1.73m 2 , or who require some form of dialysis (CKD Stage G5) are often referred to as end-stage renal failure (ESRF) . These patients tend to have more severe coronary disease and worse outcomes following percutaneous coronary intervention (PCI). Aim: To compare the in-hospital bleeding complications and major adverse cardiac and cerebrovascular (MACCE) events in CKD Stage G4 with CKD Stage G5 (dialysis) patients undergoing PCI. Methods: Between 12/2010 and 03/2018 a total of 1,534 ESRF patients underwent PCI at 6 hospitals in our system. Patients were divided into two groups, those with an CKD Stage G4 (n=954) and those on dialysis CKD Stage G5 (n=580). Bleeding complications were classified according to Bleeding Academic Research Consortium (BARC). BARC 4 (coronary bypass grafting-related bleed) and BARC 5 (fatal) bleeding events were excluded. Chi square statistical analysis was used for categorical values and t-test for continuous variables. P<0.05 was considered significant. Results: Clinical characteristics, bleeding complications, and in-hospital outcomes are shown in the Table. Patients with CKD Stage G4 were older, had a higher percentage of female patients and more often presented with a STEMI when compared with CKD Stage 5 (dialysis) patients. Bleeding (BARC ≤2 and 3) rates were similar between the two groups. Although mortality and MACCE (Death/MI/Stroke/Major Bleed) rates were numerically higher in Stage G4 patients, it did not reach statistical significance. Conclusion: In a contemporary analysis of ESRF patients undergoing PCI, CKD Stage G4 and CKD Stage G5 (dialysis) patients had low and comparable rates of moderate and severe bleeding complications. Furthermore, in hospital MACCE rates were low and similar in these two groups.