Background The influence ofalbuminuria on clinical outcomes in patients with type 2 diabetes mellitus （T2DM） after elective percutaneous coronary intervention（PCI） with drug-eluting stent （DES） implantation rema...Background The influence ofalbuminuria on clinical outcomes in patients with type 2 diabetes mellitus （T2DM） after elective percutaneous coronary intervention（PCI） with drug-eluting stent （DES） implantation remains unclear. Methods We observed 386 patients with T2DM after elective PCI. The patients were stratified based on the early morning urinary albumin： negative （n = 309）, trace （urine dipstick trace, n = 39）, and positive group （urine dipstick≥1＋, n = 38）. Kaplan-Meier curve analysis was used to compare the cumulative rates of clinical outcomes （all-cause death, cardiovascular death, MACEs： cardiovascular death, non-fatal myocardial in- farction, stroke or revascularization）. Cox regression was performed to assess the risk factors for all-cause death and cardiovascular death. Results Median follow-up was 25 months （IQR： 17-37 months）. Twenty eight （7.3%, 13 in the negative group, 3 in the trace group and 12 in the positive group） patients died during the entire study period, 2 of them （0.7%,1 in the negative group and I in the trace group）died during index hospitalization. Posi- tive albuminuria group suffered more contrast-induced acute kidney injury （CI-AKI） and dialysis during hospital- ization. The cumulative all-cause death （34.5% vs. 8.9% vs. 4.9%, P Negati Trace = 0.333, PNegati Positive 〈（ 0.001, PTracevs.Positive = 0.013, log-rank P 〈 0.001） and cardiovascular death （29.5% vs. 7.4% vs. 3.4%, P Negative vs Trace = 0.458, PNegati Positive 〈 0.001, PTrace vs.Positive = 0.014, log-rank P 〈 0.001） were highest in the positive group. MACE also tends to increase in positive group. After adjusting for potential confounding risk factors, positive albuminuria was still related to all-cause death （HR = 5.13, 95% CI： 2.21-11.89, P 〈 0.001） and cardiovascular death （HR = 5.40, 95% CI： 2.07-14.09, P = 0.001）. Conclusion Preprocedural albuminuria predicts poor clinical outcomes, including all-cause death and cardiovascular death,展开更多
基金supported by Industrial Foundation of Ministry of Health of China(No.200902001)
文摘Background The influence ofalbuminuria on clinical outcomes in patients with type 2 diabetes mellitus （T2DM） after elective percutaneous coronary intervention（PCI） with drug-eluting stent （DES） implantation remains unclear. Methods We observed 386 patients with T2DM after elective PCI. The patients were stratified based on the early morning urinary albumin： negative （n = 309）, trace （urine dipstick trace, n = 39）, and positive group （urine dipstick≥1＋, n = 38）. Kaplan-Meier curve analysis was used to compare the cumulative rates of clinical outcomes （all-cause death, cardiovascular death, MACEs： cardiovascular death, non-fatal myocardial in- farction, stroke or revascularization）. Cox regression was performed to assess the risk factors for all-cause death and cardiovascular death. Results Median follow-up was 25 months （IQR： 17-37 months）. Twenty eight （7.3%, 13 in the negative group, 3 in the trace group and 12 in the positive group） patients died during the entire study period, 2 of them （0.7%,1 in the negative group and I in the trace group）died during index hospitalization. Posi- tive albuminuria group suffered more contrast-induced acute kidney injury （CI-AKI） and dialysis during hospital- ization. The cumulative all-cause death （34.5% vs. 8.9% vs. 4.9%, P Negati Trace = 0.333, PNegati Positive 〈（ 0.001, PTracevs.Positive = 0.013, log-rank P 〈 0.001） and cardiovascular death （29.5% vs. 7.4% vs. 3.4%, P Negative vs Trace = 0.458, PNegati Positive 〈 0.001, PTrace vs.Positive = 0.014, log-rank P 〈 0.001） were highest in the positive group. MACE also tends to increase in positive group. After adjusting for potential confounding risk factors, positive albuminuria was still related to all-cause death （HR = 5.13, 95% CI： 2.21-11.89, P 〈 0.001） and cardiovascular death （HR = 5.40, 95% CI： 2.07-14.09, P = 0.001）. Conclusion Preprocedural albuminuria predicts poor clinical outcomes, including all-cause death and cardiovascular death,
