评估肾功能对接受经皮冠状动脉介入治疗的糖尿病患者不良预后的预测作用。

IF 2.1 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Acta cardiologica Pub Date : 2024-09-01 Epub Date: 2024-10-08 DOI:10.1080/00015385.2024.2410603
Farima Sadat Mousavi, Babak Bagheri, Rozita Jalalian, Maryam Nabati, Amir Moradi, Fatemeh Mousavi, Erfan Ghadirzadeh
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引用次数: 0

摘要

背景:心血管疾病仍然是全球死亡的主要原因,尤其是在接受经皮冠状动脉介入治疗(PCI)的糖尿病患者中。慢性肾脏病(CKD)对这一人群构成了额外的风险。然而,慢性肾脏病对PCI术后主要不良心血管事件(MACE)、死亡率和三血管疾病(TVD)的具体影响仍是一个争论不休的话题,尤其是在2型糖尿病(T2DM)患者中:本研究旨在探讨肾功能对接受PCI手术的糖尿病患者的MACE、死亡率和TVD的影响:对接受PCI手术的糖尿病患者的肾功能和预后进行分析。根据肾小球滤过率(GFR)对参与者进行分层。逻辑回归和接收器操作特征(ROC)分析评估了相关性和预测能力:共有 505 名患者参加了研究。在年龄、肌酐水平和罪魁祸首血管数量方面,患有和未患有慢性肾脏病的糖尿病患者之间存在明显差异。严重慢性肾脏病与较高的 1 个月死亡率相关(OR:15.694,P 值 P 值 P 值 P 值 P 值 P 值:.001)。此外,肾小球滤过率对随访 1 个月和 6 个月的死亡率有明显的预测准确性(AUC:分别为 0.77 和 0.71):结论:肾功能障碍,尤其是严重的慢性肾功能衰竭,会显著增加MACE、死亡率和TVD的风险。优化肾功能和调整心血管管理的策略可以减轻这一高风险人群的不良后果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing renal function as a predictor of adverse outcomes in diabetic patients undergoing percutaneous coronary intervention.

Background: Cardiovascular diseases remain a leading cause of global mortality, particularly among diabetic patients undergoing percutaneous coronary intervention (PCI). Chronic kidney disease (CKD) poses an additional risk in this population. Yet, its specific impact on major adverse cardiovascular events (MACEs), mortality, and triple vessel disease (TVD) post-PCI remains a topic of debate, specifically in patients with type 2 diabetes mellitus (T2DM).

Objective: This study aimed to examine the impact of renal function on MACE, mortality, and TVD among diabetic patients undergoing PCI.

Methods: Diabetic patients undergoing PCI were analysed for renal function and outcomes. Participants were stratified by glomerular filtration rate (GFR). Logistic regression and receiver operating characteristic (ROC) analysis assessed associations and predictive capabilities.

Results: A total of 505 patients enrolled in the study. A significant difference was observed regarding age, creatinine levels, and number of culprit vessels between diabetics with and without CKD. Severe CKD was associated with higher odds of 1-month mortality (OR: 15.694, p value <.001), 1-month MACE (OR: 7.734, p value <.001), and TVD (OR: 3.740, p value <.001). Patients with severe CKD also had significantly higher odds of 6-months mortality (OR: 12.192, p value <.001) and 6-months MACE (OR: 3.848, p value: .001). Moreover, GFR showed significant predictive accuracy for mortality at one- and six-months follow-up (AUC: 0.77 and 0.71, respectively).

Conclusions: Renal dysfunction, particularly severe CKD, significantly elevates risks of MACE, mortality, and TVD. Strategies to optimise renal function and tailor cardiovascular management could mitigate adverse outcomes in this high-risk population.

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来源期刊
Acta cardiologica
Acta cardiologica 医学-心血管系统
CiteScore
2.50
自引率
12.50%
发文量
115
审稿时长
2 months
期刊介绍: Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.
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