Impact of chronic kidney disease and diabetes on clinical outcomes in women undergoing PCI.
EuroIntervention
; 19(6): 493-501, 2023 Aug 21.
Article
en En
| MEDLINE
| ID: mdl-37382924
ABSTRACT
BACKGROUND:
For women undergoing drug-eluting stent (DES) implantation, the individual and combined impact of chronic kidney disease (CKD) and diabetes mellitus (DM) on outcomes is uncertain.AIMS:
We sought to assess the impact of CKD and DM on prognosis in women after DES implantation.METHODS:
We pooled patient-level data on women from 26 randomised controlled trials comparing stent types. Women receiving DES were stratified into 4 groups based on CKD (defined as creatine clearance <60 mL/min) and DM status. The primary outcome at 3 years after percutaneous coronary intervention was the composite of all-cause death or myocardial infarction (MI); secondary outcomes included cardiac death, stent thrombosis and target lesion revascularisation.RESULTS:
Among 4,269 women, 1,822 (42.7%) had no CKD/DM, 978 (22.9%) had CKD alone, 981 (23.0%) had DM alone, and 488 (11.4%) had both conditions. The risk of all-cause death or MI was not increased in women with CKD alone (adjusted hazard ratio [adj. HR] 1.19, 95% confidence interval [CI] 0.88-1.61) nor DM alone (adj. HR 1.27, 95% CI 0.94-1.70), but was significantly higher in women with both conditions (adj. HR 2.64, 95% CI 1.95-3.56; interaction p-value <0.001). CKD and DM in combination were associated with an increased risk of all secondary outcomes, whereas alone, each condition was only associated with all-cause death and cardiac death.CONCLUSIONS:
Among women receiving DES, the combined presence of CKD and DM was associated with a higher risk of the composite of death or MI and of any secondary outcome, whereas alone, each condition was associated with an increase in all-cause and cardiac death.
Texto completo:
1
Base de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Diabetes Mellitus
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Insuficiencia Renal Crónica
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Stents Liberadores de Fármacos
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Intervención Coronaria Percutánea
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Infarto del Miocardio
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Prognostic_studies
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Risk_factors_studies
Idioma:
En
Revista:
EuroIntervention
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
/
TERAPEUTICA
Año:
2023
Tipo del documento:
Article