Impact of diabetes mellitus on long-term clinical outcomes of patients on chronic hemodialysis after percutaneous coronary intervention.
Citation: Journal of Interventional Cardiology. 25(2):147-55, 2012 Apr.PMID: 22010995Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Angioplasty, Balloon, Coronary | *Diabetic Angiopathies/ep [Epidemiology] | *Diabetic Nephropathies/ep [Epidemiology] | Aged | Comorbidity | Coronary Angiography | Coronary Restenosis/ep [Epidemiology] | Coronary Restenosis/th [Therapy] | Diabetic Angiopathies/th [Therapy] | Diabetic Nephropathies/th [Therapy] | Drug-Eluting Stents | Female | Humans | Kidney Failure, Chronic | Male | Middle Aged | Renal Dialysis | Retreatment/sn [Statistics & Numerical Data]Year: 2012ISSN:- 0896-4327
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 22010995 | Available | 22010995 |
BACKGROUND: End-stage renal disease (ESRD) is known to correlate with poor outcome in patients undergoing percutaneous coronary intervention (PCI). This study examines the impact of diabetes mellitus (DM) on the long-term outcome of patients with ESRD on chronic hemodialysis.
CONCLUSION: The prognosis of patients with ESRD after PCI is dismal with a very high overall mortality rate regardless of the presence of DM. Patients with ESRD appear to be at higher risk for the need of revascularization. 2011 Wiley Periodicals, Inc.
METHODS: A cohort of patients with ESRD on chronic hemodialysis, who underwent PCI with drug-eluting stents, was followed for 1 year. The clinical outcome in this population was compared retrospectively based on the presence of DM. Major adverse cardiac events (MACE) as the composite of all-cause death, Q-wave myocardial infarction and target lesion revascularization (TLR), as well as TLR as an individual outcome, were the main end points of the study.
RESULTS: In the study cohort (n = 198), 48.5% had DM. Diabetic patients were more commonly female. The lesion characteristics were similar between groups except for more frequent saphenous vein graft intervention in nondiabetics. At 1-year follow-up there was no difference in the rate of MACE between diabetic and nondiabetic patients (40.4% vs. 39.3%, respectively, p = 0.89), driven primarily by a very high mortality rate (1-year overall mortality of 33.5%). After adjustment for the relevant clinical co-variables, DM was not associated with the composite end point. However, diabetic patients had a significantly higher incidence of 1-year TLR compared to nondiabetics (13.8% vs. 3.6%, respectively, p = 0.04).
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