Influence Of Basic Renal Function On The Total Clinical Efficacy Of Successful Percutaneous Coronary Intervention In Patients With Chronic Occlusion

ObjectiveTo observe the influence of different estimated glomerular filtration rate(eGFR) on the improvement of cardiac function through percutaneous coronary intervention for patients with chronic total occlusion(CTO).Method44 consecutive patients who were admitted to our hospital ranging from June 2014 to March 2015 were divided into two groups according to a baseline estimated glomerular filtration rate (e-GFR):e-GFR< 90ml/min (A group,n=24), e-GFR> 90ml/min,(B group,n=20).After recording the preoperational baseline clinical data, the operation data, we analyze the echocardiographic data, the NYHA and CCS classification within the postoperational 1 month,3months and 12 months and record the MACE events.ResultsAfter successful PCI,44 patients received at least one echocardiographic ultrasound and were evaluated the NYHA and CCS classification after the operation. There is significant difference between the preoperational creatinine (91.8±15.6umol/L) and postoperative creatinine (86.4±14.9umol/L) in A group. The preoperative creatinine of non-CKD group is 62.3±9.3,the postoperative creatinine is 69.5±15.2umol/L, no significant difference is found and three patients encountered the contrast-induced nephropathy. By recording the left ventricular ejection fraction(LVEF),NYHA and CCS classification in the 1-month,3-month and 12-month follow up. No significant difference in the first three months of LVEF was seen(P> 0.05).LVEF of 12 months after operation showed the significant improvement in the non-CKD group(66.8±5.5 versus 66.0±12.7),but not in the CKD group. NYHA classification was significantly improved after the operation regardless of the basic renal function. After excluding the CCS I patients, the CCS classification also showed the similar results. During the follow up, only one patient encountered NSTEMI, no obvious difference in the long-term survival.ConclusionContrast to the CKD group, non-CKD patients received more significant improvement in the LVEF. All patients’symptoms with CTO got significant relief regardless of the basic renal function. With the well-prepared medical therapy, the morbidity of contrast-induced nephropathy in the CKD group can be similar to the non-CKD group.