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Titel:

Impact of chronic kidney disease and diabetes on clinical outcomes in women undergoing PCI.

Dokumenttyp:
Journal Article; Review
Autor(en):
Spirito, Alessandro; Itchhaporia, Dipti; Sartori, Samantha; Camenzind, Edoardo; Chieffo, Alaide; Dangas, George D; Galatius, Soren; Jeger, Raban V; Kandzari, David E; Kastrati, Adnan; Kim, Hyo-Soo; Kimura, Takeshi; Leon, Martin B; Mehta, Laxmi S; Mikhail, Ghada W; Morice, Marie-Claude; Nicolas, Johny; Pileggi, Brunna; Serruys, Patrick W; Smits, Pieter C; Steg, P Gabriel; Stone, Gregg W; Valgimigli, Marco; Vogel, Birgit; von Birgelen, Clemens; Weisz, Giora; Wijns, William; Windecker, Stephan; Meh...     »
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.
Zeitschriftentitel:
EuroIntervention
Jahr:
2023
Band / Volume:
19
Heft / Issue:
6
Seitenangaben Beitrag:
493-501
Volltext / DOI:
doi:10.4244/EIJ-D-23-00086
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/37382924
Print-ISSN:
1774-024X
TUM Einrichtung:
Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)
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