Prognostic Relation Between Severity of Diabetes Mellitus (On or Off Insulin) ± Chronic Kidney Disease with Cardiovascular Risk After Percutaneous Coronary Intervention

Surbhi Chamaria, Samit Bhatheja, Yuliya Vengrenyuk, Joseph Sweeny, Hasan Choudhury, Nitin Barman, Roxana Mehran, Samin Sharma, Usman Baber, Annapoorna Kini

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

The presence of either diabetes mellitus (DM) or chronic kidney disease (CKD) is associated with a worse prognosis after percutaneous coronary intervention (PCI). It is also known that outcomes in patients treated with insulin (insulin requiring type 2 diabetes mellitus [ITDM]) are worse than those who are not on insulin (non–insulin type 2 diabetes mellitus [NITDM]). We sought to compare long-term outcomes in patients who underwent PCI with varying severity of DM with and without CKD. We retrospectively studied 17,898 patients who underwent PCI from January 2009 to December 2014 in the Mount Sinai Cath Lab. Patients were categorized into groups by the presence or the absence of CKD and by the DM status (none, NITDM, or ITDM). In the absence of CKD, adjusted hazard ratios (95% confidence interval [CI]) for death or myocardial infarction associated with NITDM and ITDM were 1.65 (95% CI 1.02 to 2.67) and 3.78 (95% CI 2.23 to 6.40), respectively. Analogous risks in the presence of CKD were 3.34 (95% CI 1.99 to 5.61) and 6.26 (95% CI 3.84 to 10.2). This study shows that irrespective of renal status, the need for insulin in the setting of DM identifies a group with substantial risk of death or myocardial infarction at 1 year.

Original languageEnglish
Pages (from-to)168-176
Number of pages9
JournalAmerican Journal of Cardiology
Volume121
Issue number2
DOIs
StatePublished - 15 Jan 2018

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