The Impact of Renal Dysfunction on the Long Term Clinical Outcomes of Diabetic Patients Undergoing Percutaneous Coronary Intervention in the Drug-Eluting Stent Era

被引:4
|
作者
Choi, Ki Hong [1 ]
Yang, Jeong Hoon [1 ,2 ]
Kim, Ji Hwan [1 ]
Song, Young Bin [1 ]
Hahn, Joo-Yong [1 ]
Choi, Jin-Ho [1 ,3 ]
Gwon, Hyeon-Cheol [1 ]
Lee, Sang Hoon [1 ]
Choi, Seung-Hyuk [1 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Div Cardiol,Dept Med,Cardiac & Vasc Ctr, Seoul, South Korea
[2] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Crit Care Med, Seoul, South Korea
[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Dept Emergency Med, Seoul, South Korea
来源
PLOS ONE | 2016年 / 11卷 / 01期
关键词
CHRONIC KIDNEY-DISEASE; ASSOCIATION TASK-FORCE; PRACTICE GUIDELINES; SERUM CREATININE; MORTALITY; RISK; INSUFFICIENCY; THROMBOSIS; PROGNOSIS; PROTEINURIA;
D O I
10.1371/journal.pone.0141846
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Limited data are available regarding the association between renal dysfunction and clinical outcomes in diabetic patients undergoing percutaneous coronary intervention (PCI) in the drug-eluting stent (DES) era. Methods Between March 2003 and December 2010, 2,181 diabetic patients were enrolled in a single- center registry. We divided diabetic patients into a renal dysfunction group (n = 518) and a non-renal dysfunction group (n = 1,663) according to a baseline estimated glomerular filtration rate <60 mL/min/1.73 m(2). Propensity score matching analysis was also performed. The primary outcome was cardiac death. Results The median follow-up duration was 48 months. The rate of cardiac death was higher in the renal dysfunction group than in the non-renal dysfunction group (14.3% vs. 3.0%, adjusted hazard ratio [HR] 3.63, 95% confidence interval [CI] 2.47 to 5.35, p<0.001). Similarly, the incidence of stent thrombosis was significantly higher in the renal dysfunction group than in the non-renal dysfunction group (4.1% vs. 1.4%, adjusted HR 1.90, 95% CI 1.02 to 3.56, p = 0.04). After 1: 1 propensity score matching (502 pairs), patients with renal dysfunction still had a higher rate of cardiac death (13.3% vs. 4.8%, HR 2.58, 95% CI 1.52 to 4.38, p<0.001) although there was no significant difference in the rate of stent thrombosis (4.0% vs. 2.8%, HR 1.31, 95% CI 0.64 to 2.69, p = 0.47). Conclusions Renal dysfunction is associated with long-term mortality for diabetic patients undergoing PCI in the DES era.
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页数:10
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