Cardiac Rehabilitation Improves Long-Term Prognosis for People with Chronic Kidney Disease Undergoing Percutaneous Coronary Intervention: A Propensity Matching Analysis

Abstract

Objectives. According to researches, many people with chronic kidney disease (CKD) had the higher incidence rate and mortality rate of coronary artery disease (CAD) after percutaneous coronary intervention than those who did not receive percutaneous coronary intervention, while coronary rehabilitation was beneficial for patients who received percutaneous coronary intervention I. This study aims to analyze whether coronary rehabilitation was beneficial to patients with CKD after percutaneous coronary intervention. Patients and Methods. A retrospective survey was used to collect clinical data of patients undergoing percutaneous coronary intervention due to CAD, and CKD patients were screened for further analysis. According to whether patients had received coronary rehabilitation treatment, research subjects were divided into two groups, the coronary rehabilitation group and the noncoronary rehabilitation group. The baseline characteristics of the propensity score matching between the two groups were compared. Survival analysis used the Cox hazard ratio (HR) model as regression method to compare the relative risk of the endpoints in the coronary rehabilitation group and the noncoronary rehabilitation group. Results. From January 2007 to January 2012, a total of 246 CKD patients treated with percutaneous coronary intervention were included in this study, and 106 of them obtained coronary rehabilitation after surgery. After propensity score matching, there were 89 pairs of patients in the two groups who had no significant difference in demographic and clinical characteristics (all $P>0.05$ ). CKD patients receiving coronary rehabilitation had a significant reduction in all-cause mortality (HR 0.465, 95% CI 0.233–0.926, $P=0.029$ ) and cardiac complications (HR 0.532, 95% CI 0.287–0.984, $P=0.044$ ). Survival analysis showed that the survival rate of the coronary rehabilitation group was significantly higher than that of the noncoronary rehabilitation group $\left(P=0.024\right)$ . Conclusions. For CKD patients undergoing percutaneous coronary intervention, receiving cardiac rehabilitation can significantly improve long-term survival and reduce cardiac events.