Coronary artery diseaseIncidence, Predictors, and Outcomes of Post-Percutaneous Coronary Intervention Nephropathy in Patients With Diabetes Mellitus and Normal Baseline Serum Creatinine Levels
Section snippets
Patient population and study design
The study population was taken from a consecutive series of patients entered into a prospective registry who underwent PCI at our institution from August 2004 to December 2006. To be included in the study, patients were required to have diabetes mellitus requiring treatment with either oral hypoglycemic agents or insulin, have normal baseline creatinine levels (≤1.3 mg/dl), and have completed 6-month follow-up. Patients aged >75 years and those presenting with either acute myocardial infarction
Incidence
Post-PCI SCr increases occurred in 70 of 570 patients (12.3%).
Baseline patient characteristics
Clinical and procedural details are listed in Table 1, Table 2. Patients who developed SCr increases after PCI were more often women (55.7% vs 35.5%, p = 0.001) and had more frequent previous congestive heart failure (24.2% vs 14.7%, p = 0.05). Insulin-requiring diabetes mellitus was well matched between groups. Baseline creatinine was significantly lower in the group with SCr increases (0.84 ± 0.2 vs 0.97 ± 0.2 mg/dl, p <0.001;
Discussion
The present study draws attention to several important facets of the risk for post-PCI nephropathy. Post-PCI increases in SCr are not infrequent in patients with treated diabetes and normal baseline values. The study also confirmed the detrimental impact on prognosis of post-PCI nephropathy in this selected population. In addition, the predictors of post-PCI nephropathy (lower body mass index and blood transfusions) may identify those who are at increased risk and should be monitored more
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