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BACKGROUND: Chronic renal disease (CRD) is a well-known risk factor for bleeding complications in acute coronary syndrome patients. AIM: To determine the impact of CRD with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) on periprocedural complications. METHODS: 103 patients with STEMI treated with pPCI were prospectively observed for in-hospital complications and analysed according to kidney function status. Endpoints included clinical and periprocedural outcomes. Major and minor bleedings were reported according to TIMI, REPLACE2 and EASY classifications. RESULTS: Patients with CRD were at greater risk of major bleeding defined by RAPLACE-2 (20.0% vs. 2.7%; p = 0.007) and TIMI(13.3% vs. 1.3%, p = 0.018) classifications and had more grade 2 EASY scale haematomas (20.0% vs. 2.7%; p = 0.007). Vascular access crossover during PCI occurred eight-fold more often among CRD patients (33.3% vs. 4.0%, p < 0.001). Grade 3 TIMI flow was achieved less frequently in CRD patients (60% vs. 89.3%, p = 0.004). CRD predisposed to contrast-induced nephropathy (35.7% vs. 5.7%; p < 0.001) and ischaemic stroke (14.3% vs. 0.0%; p = 0.004). CONCLUSIONS: CRD in STEMI patients undergoing pPCI is a risk factor for major and minor bleeding complications including major bleeding, moderate haematomas, contrast-induced nephropathy and ischaemic stroke. Treatment and diagnostic measures should be taken in CRD patients to reduce the severity of periprocedural complications.

Original publication

DOI

10.5603/KP.a2013.0282

Type

Journal article

Journal

Kardiol Pol

Publication Date

2014

Volume

72

Pages

231 - 238

Keywords

Aged, Female, Humans, Inpatients, Male, Middle Aged, Myocardial Infarction, Percutaneous Coronary Intervention, Renal Insufficiency, Risk Assessment, Risk Factors, Treatment Outcome