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The impact of stage of chronic kidney disease on the outcomes of diabetics with acute myocardial infarction treated with percutaneous coronary intervention

  • Nephrology - Original Paper
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Abstract

Background

Patients with diabetes mellitus (DM) or chronic kidney disease (CKD) have a high risk of acute myocardial infarction and recurrent cardiovascular events. According to the previous studies, the combination of the two conditions may have a synergistic impact on prognosis. The aim of this study was to assess the impact of stage of CKD on the outcomes of patients with DM and ST-elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI).

Methods

Study population consisted of 946 consecutive patients with STEMI who underwent PCI from January 2009 to December 2012 and were followed up until the end of 2013. The all-cause mortality during this period was evaluated in relation to DM and severe or moderate reduction in glomerular filtration rate (GFR categories G4–5, or G3; KDIGO classification). Cox regression analysis adjusted for possible confounding factors was used in statistics.

Results

Out of the study population (mean age 63 years, 69.6 % males), 217 (22.9 %) patients had DM. Of them, 10.6 % were in GFR category G4–5 and 32.7 % in G3. The in-hospital mortality rates in patients with DM were 34.8 % for G4–5, 18.3 % for G3, and 4.1 % in G1–2 groups. The all-cause mortality at the end of the follow-up period for diabetics within G4–5 was 2.27 –times higher compared to mortality of diabetics in G1–2 (p = 0.047, Cox regression analysis), and there was a trend toward higher mortality for G3 versus G1–2 (HR 1.64, p = 0.12).

Conclusion

Severe chronic kidney disease (GFR category 4–5) was significantly associated with all-cause mortality of diabetics with STEMI treated with PCI; the association with severe CKD was stronger compared to moderate CKD.

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Acknowledgments

This work was supported by the Third Faculty of Medicine, Charles University Prague, Research Project UNCE204010 and Research Project PRVOUK P35.

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Authors and Affiliations

  1. Cardiocentre, Third Faculty of Medicine Charles University and University Hospital Kralovske Vinohrady, Srobarova 50, 10034, Prague, Czech Republic

    Teodora Vichova, Jiri Knot, Jaroslav Ulman & Zuzana Motovska

  2. Department of Biostatistics and Informatics, National Institute of Public Health, Srobarova 48, 10042, Prague, Czech Republic

    Marek Maly

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  1. Teodora Vichova
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  2. Jiri Knot
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Correspondence to Zuzana Motovska.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and National Research Committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Vichova, T., Knot, J., Ulman, J. et al. The impact of stage of chronic kidney disease on the outcomes of diabetics with acute myocardial infarction treated with percutaneous coronary intervention. Int Urol Nephrol 48, 1137–1143 (2016). https://doi.org/10.1007/s11255-016-1260-9

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  • DOI: https://doi.org/10.1007/s11255-016-1260-9

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