Abstract
BackgroundThe effect of diabetes mellitus (DM) and chronic kidney disease (CKD) on long-term outcomes in patients receiving percutaneous coronary intervention (PCI) is unclear.MethodsA total of 1394 patients who underwent PCI were prospectively enrolled and divided into 4 groups according to the presence or absence of DM or CKD. Baseline characteristics, risk factors, medications, and angiographic findings were compared. Determinants of long-term outcomes in patients undergoing PCI were analyzed.ResultsPatients with DM and CKD had the highest all-cause mortality and cardiovascular mortality (both P < 0.01) but there were no differences existed in myocardial infarction (MI) or repeated PCI among the 4 groups (P = 0.19, P = 0.87, respectively). Patients with DM and CKD had the lowest even-free rate of all-cause mortality, cardiovascular mortality, MI, and repeated PCI (P < 0.001, P < 0.001, P < 0.001, and P = 0.002, respectively). In the Cox proportional hazard model, patients with both DM and CKD had the highest risk of all-cause mortality (HR: 3.25, 95% CI: 1.85–5.59), cardiovascular mortality (HR: 3.58, 95% CI: 1.97–6.49), MI (HR: 2.43, 95% CI: 1.23–4.08), and repeated PCI (HR: 1.79, 95% CI: 1.33–2.41). Patients with CKD alone had the second highest risk of all-cause mortality (HR: 2.04, 95% CI: 1.15–3.63), cardiovascular mortality (HR: 2.13, 95% CI: 1.13–4.01), and repeated PCI (HR: 1.47, 95% CI: 1.09–1.97).ConclusionsDM and CKD had additive effect on adverse long-term outcomes in patients receiving PCI; CKD was a more significant adverse predictor than DM.
Highlights
The effect of diabetes mellitus (DM) and chronic kidney disease (CKD) on long-term outcomes in patients receiving percutaneous coronary intervention (PCI) is unclear
Patients with Diabetes mellitus (DM) and CKD had the highest all-cause mortality and cardiovascular mortality but there were no differences existed in myocardial infarction (MI) or repeated Percutaneous coronary intervention (PCI) among the 4 groups (P = 0.19, P = 0.87, respectively)
In the Cox proportional hazard model, patients with both DM and CKD had the highest risk of all-cause mortality (HR: 3.25, 95% CI: 1.85–5.59), cardiovascular mortality (HR: 3.58, 95% CI: 1.97–6.49), MI (HR: 2. 43, 95% CI: 1.23–4.08), and repeated PCI (HR: 1.79, 95% CI: 1.33–2.41)
Summary
The effect of diabetes mellitus (DM) and chronic kidney disease (CKD) on long-term outcomes in patients receiving percutaneous coronary intervention (PCI) is unclear. Percutaneous coronary intervention (PCI) is common in patients with coronary artery disease(CAD). A lot of risk factors will affect the outcome after patients receiving PCI. Diabetes mellitus (DM) is a major risk factor that affects outcomes in CAD patients undergoing PCI [1,2,3]. The impact of DM and CKD on outcomes has been well studied in patients with acute coronary syndrome (ACS) undergoing PCI. As for patients with stable CAD who underwent PCI, Lin et al BMC Cardiovascular Disorders (2017) 17:242 diabetes was still an adverse predictor of mid-term outcomes
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