White blood cells, age, and left ventricular ejection fraction (LVEF) were independent prognostic factors for major adverse cardiovascular events (MACE) in ACS patients with moderate to severe CKD after PCI, while CKD stage was not associated with MACE occurrence.
The incidence of MACE at 12 months after PCI was 33.8% in ACS patients complicated with moderate to severe CKD.
White blood cell count was an independent risk factor for MACE at 12 months after PCI.
Age was an independent risk factor for MACE at 12 months after PCI.
Left ventricular ejection fraction (LVEF) was an independent protective factor against MACE at 12 months after PCI.
CKD stage was not associated with the occurrence of MACE at 12 months after PCI.
A risk prediction model for MACE was established with good predictive efficiency.
This research suggests that among patients who have both acute coronary syndrome (a group of conditions caused by reduced blood flow to the heart) and moderate to severe chronic kidney disease, the risk of serious heart-related complications within one year after a procedure to open blocked heart arteries (PCI) is substantial — about 1 in 3 patients (33.8%) experienced a major adverse cardiovascular event (MACE). The study followed 148 such patients treated at a major Chinese hospital and compared those who did and did not experience MACE over 12 months. The researchers found that three factors measured during the initial hospitalization independently predicted whether a patient would experience MACE: older age, higher white blood cell count (a marker often associated with inflammation or infection), and lower heart pumping function (LVEF). Notably, the specific stage of kidney disease (within the moderate-to-severe range) did not make a significant difference in predicting outcomes. Using these three factors, the team built a predictive scoring model that showed reasonable ability to identify high-risk patients, with an area under the ROC curve of 0.749 and sensitivity and specificity of 72% and 68%, respectively. This research suggests that clinicians caring for this high-risk group of patients might pay particular attention to inflammatory markers like white blood cell count and heart function measures like LVEF, alongside patient age, when assessing prognosis after heart artery procedures. The findings could help guide closer monitoring or more intensive management for patients identified as higher risk by these factors.
Cui J, Wang F, Li D, Sun L, Chen B, Han J. (2026). [Analysis of prognostic factors in patients with acute coronary syndrome complicated with moderate to severe chronic kidney disease after percutaneous coronary intervention].. Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences. https://pubmed.ncbi.nlm.nih.gov/42880918/