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

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; ... (2023). Impact of chronic kidney disease and diabetes on clinical outcomes in women undergoing PCI. EuroIntervention, 19(6), pp. 493-501. Europa Digital & Publishing 10.4244/EIJ-D-23-00086

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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 (adj. hazard ratio [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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1774-024X

Publisher:

Europa Digital & Publishing

Language:

English

Submitter:

Pubmed Import

Date Deposited:

03 Jul 2023 14:38

Last Modified:

23 Aug 2023 00:14

Publisher DOI:

10.4244/EIJ-D-23-00086

PubMed ID:

37382924

URI:

https://boris.unibe.ch/id/eprint/184266

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