Korean Circulation Journal

  • 제47권2호
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  • Pages.222-230
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  • 2017
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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Impact of Chronic Kidney Disease on Clinical Outcomes in Diabetic Patients Undergoing Percutaneous Coronary Intervention in the Era of Newer-Generation Drug-Eluting Stents

  • Kim, Su-Min (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Tripathy, Dipti Ranjan (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Park, Sang Wook (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Park, Bonil (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Son, Jung-Woo (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Jun-Won (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Youn, Young Jin (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Ahn, Sung-Gyun (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Ahn, Min Soo (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Jang-Young (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Yoo, Byung-Su (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Seung-Hwan (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine) ;
  • Yoon, Junghan (Division of Cardiology, Department of Internal Medicine, Yonsei University Wonju College of Medicine)
  • 투고 : 2016.08.29
  • 심사 : 2016.11.22
  • 발행 : 2017.03.31
⟨ 이전 논문 다음 논문 ⟩

초록

Background and Objectives: Chronic kidney disease (CKD) is known to be a major adverse predictor in diabetes mellitus (DM) patients undergoing percutaneous coronary intervention (PCI). It is expected that the use of newer-generation drug-eluting stents (DES) would improve clinical outcomes in these patients. We evaluated the impact of CKD on clinical outcomes in diabetic patients undergoing PCI using newer-generation DES in a real-world setting. Subjects and Methods: A total of 887 patients who underwent PCI with newer-generation DES and who had a history of DM or HbA1c >6.5% at the time of hospitalization were analyzed. These patients were divided into groups without CKD (n=549) and with CKD (n=338). Among survivors at discharge, a patient-oriented composite outcome (POCO) including all-cause mortality, myocardial infarction (MI), and revascularization was evaluated, together with a device-oriented composite outcome (DOCO) including cardiac death, target vessel-related MI, and target lesion revascularization at a follow-up period of one year. Results: The incidence of POCO (5.4% vs. 14.0%, log-rank p<0.001) and DOCO (1.1% vs. 4.1%, log-rank p<0.001) was higher in patients with CKD. According to multivariate analysis, which was adjusted for baseline differences in demographic, clinical, and angiographic factors, the presence of CKD was an independent predictor of POCO (hazard ratio [HR]: 1.82, 95% confidence interval [CI]: 1.07 to 3.12), but not of DOCO (HR 2.08, 95% CI: 0.69-6.28). Conclusion: In DM patients, CKD is an independent and powerful predictor of patient-related outcomes, but not of device-related outcomes in the era of newer-generation DES.

키워드

참고문헌

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피인용 문헌

  1. Safety and effectiveness of percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents for calcified coronary artery lesions in patients with chronic kidney vol.73, pp.3, 2017, https://doi.org/10.1016/j.ihj.2021.04.007
  2. Impact of chronic kidney disease on long-term outcomes for coronary in-stent restenosis after drug-coated balloon angioplasty vol.78, pp.6, 2021, https://doi.org/10.1016/j.jjcc.2021.08.010
  3. The roles of sodium and volume overload on hypertension in chronic kidney disease vol.40, pp.4, 2021, https://doi.org/10.23876/j.krcp.21.800