Chronic kidney disease and diabetes associated with long-term outcomes in patients receiving percutaneous coronary intervention

Abstract

Background: The effect of diabetes mellitus (DM) and chronic kidney disease (CKD) on long-term outcomes in patients receiving percutaneous coronary intervention (PCI) is unclear. Methods: A 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. Results: Patients 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). Conclusions: DM and CKD had additive effect on adverse long-term outcomes in patients receiving PCI; CKD was a more significant adverse predictor than DM.