P215 - PATIENT ACCEPTABILITY THRESHOLD FOR POTENTIAL RENAL COMPLICATIONS FOLLOWING CORONARY ANGIOGRAPHY AND/OR PERCUTANEOUS CORONARY INTERVENTION (PCI)

Background: CI-AKI is a common complication of coronary angiography/PCI. Although it is frequently used as a primary endpoint measure in clinical trials, its true impact on the patient’s lived experience of the disease can be variable, as it is often asymptomatic and self-resolving. Patient preferences regarding renal outcomes following coronary angiography/PCI have never been studied. The aim of this study is to identify these preferences to develop a patient-centered endpoint for future clinical trials.

METHODS AND RESULTS: A survey developed with the help of patient partners was distributed to 200 patients for whom a coronary angiography was planned. Participants were asked to indicate the outcome they consider the worst and the least bad (maximum difference scale) among 6 potential renal outcomes. A severity score was calculated for each outcome. Patient knowledge about CI-AKI, their interest in being informed about renal complications, and their acceptability thresholds under both elective and urgent clinical scenarios, were also explored.
Among the 200 patients surveyed, permanent dialysis (score = 0.53) and death due to renal complications (score = 0.69) were consistently rated as the worst outcomes. In contrast, temporary asymptomatic renal dysfunction received the lowest severity score (score = –0.90). The majority of patients (88%) expressed willingness to undergo coronary angiography if the only potential complication was temporary, asymptomatic kidney injury, while fewer (22%) were willing if there was a high risk of permanent dialysis. When asked whether they would like to be informed about serious potential renal risks prior to their procedure, 60% said yes. Awareness of renal risks and understanding of serum creatinine as a kidney function marker were variable, with just over half of patients knowing that creatinine is used to assess kidney function.

Conclusion: This is the first study to systematically assess patient preferences regarding renal outcomes following coronary angiography or PCI. The findings show that patients make clear distinctions between types of renal injury, placing far greater concern on outcomes with permanent impact or quality-of-life implications. These insights underscore the importance of developing endpoints in clinical trials that better reflect patient priorities and lived experiences. Future studies should continue to explore the integration of patient-centered metrics in the evaluation of procedural risk and benefit.