{
  "abstract": "Background Acute kidney injury (AKI) often complicates percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG). However, evidence on the incidence and prognostic impact of AKI after revascularisation for left main coronary artery disease (LMCAD) is scant, especially in terms of subsequent risk of persistent renal dysfunction (RD).Methods All consecutive patients undergoing PCI or CABG for LMCAD in two European institutions from 2015 to 2022 were enrolled. The coprimary endpoints were AKI, defined as an increase in serum creatinine (sCr) levels ≥0.3 mg/dL or increase by >50% as compared with baseline levels, and persistent RD, defined as a persistent increase of sCr at 1 year. The secondary endpoint was all-cause mortality. The risk of AKI with PCI versus CABG was assessed with multivariable logistic regression and inverse probability of treatment weighting (IPTW). The prognostic impact of transient and persistent RD at 1 year was evaluated with Cox regression analysis.Results 1047 patients were included (PCI: 617, CABG: 430). Patients undergoing PCI were older, more often male and affected by chronic kidney disease. AKI occurred in 17% and 28% of patients after PCI and CABG, respectively (adjusted OR 2.82; 95% CI 1.89 to 4.21). Consistent findings were observed after IPTW. AKI was associated with increased 1-year risk of all-cause death, irrespective of revascularisation strategy, but only persistent RD (HR 9.56; 95% CI 4.06 to 22.53) worsened patients’ prognosis, unlike AKI with only transient RD (HR 0.65; 95% CI 0.08 to 5.04).Conclusions AKI is common after LMCAD revascularisation and occurred more frequently following CABG than PCI. AKI has a substantial prognostic impact irrespective of revascularisation modality, but only when resulting in persistent RD.",
  "authors": [
    {
      "affiliations": [
        "Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy",
        "Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Laura Novelli"
    },
    {
      "affiliations": [
        "Inherited Cardiac Diseases Unit. Department of Cardiology, Hospital Politécnico y Universitario La Fe, Valencia, Spain",
        "Centro de Investigacion Biomedica en Red, Madrid, Spain"
      ],
      "name": "Jorge Sanz-Sanchez"
    },
    {
      "affiliations": [
        "IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Alessandra Iaccarino"
    },
    {
      "affiliations": [
        "Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy",
        "Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Angelo Oliva"
    },
    {
      "affiliations": [
        "Ospedale Galeazzi - Sant’Ambrogio Centro Cardiotoracico, Milan, Italy",
        "Department of Clinical and Biomedical Sciences, University of Milan, Milan, Italy"
      ],
      "name": "Riccardo Terzi"
    },
    {
      "affiliations": [
        "Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Gabriele Luigi Gasparini"
    },
    {
      "affiliations": [
        "Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Damiano Regazzoli"
    },
    {
      "affiliations": [
        "Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Antonio Mangieri"
    },
    {
      "affiliations": [
        "Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy",
        "Cardio Center, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Gaia Cantisani"
    },
    {
      "affiliations": [
        "Department of Cardiac Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Alessandro Barbone"
    },
    {
      "affiliations": [
        "Hospital Politécnico y Universitario La Fe, Valencia, Spain"
      ],
      "name": "Jose Sorolla Romero"
    },
    {
      "affiliations": [
        "IRCCS Humanitas Research Hospital, Rozzano, Italy",
        "Humanitas University, Milan, Italy"
      ],
      "name": "Giuseppe Ferrante"
    },
    {
      "affiliations": [
        "La Fe University and Polytechnic Hospital, Valencia, Spain"
      ],
      "name": "Luis Martínez Dolz"
    },
    {
      "affiliations": [
        "IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Antonio Colombo"
    },
    {
      "affiliations": [
        "Cardiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA"
      ],
      "name": "Roxana Mehran"
    },
    {
      "affiliations": [
        "Department of Cardiac Surgery, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Lucia Torracca"
    },
    {
      "affiliations": [
        "Cardiovascular Medicine, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Bernhard Reimers"
    },
    {
      "affiliations": [
        "Cardiology, Hospital Universitari i Politecnic La Fe, Valencia, Spain",
        "CIBERCV, Madrid, Spain"
      ],
      "name": "Jose L Luis Diez Gil"
    },
    {
      "affiliations": [
        "Humanitas University, Milan, Italy",
        "Cardiovascular Department, IRCCS Humanitas Research Hospital, Rozzano, Italy"
      ],
      "name": "Giulio Stefanini"
    },
    {
      "affiliations": [
        "Istituto Clinico Humanitas, Rozzano, Italy"
      ],
      "name": "Mauro Chiarito"
    }
  ],
  "title": "Left main percutaneous or surgical revascularisation and subsequent risk of transient and persistent renal dysfunction",
  "uid": "c017b967-5614-5cf4-9089-363d7c345461"
}