Key result
Reduced renal function and diabetic nephropathy in PTCA patients are linked to shorter mean survival.
Why the study?
Does reduced renal function with or without diabetic nephropathy worsen long-term survival after PTCA compared to normal renal function?
Case-Control (n=122)
Does reduced renal function with or without diabetic nephropathy worsen long-term survival after PTCA compared to normal renal function?
p-value: p=<0.001
Patients with diabetic nephropathy and moderately reduced renal function have a particularly poor prognosis and higher mortality after PTCA compared to those with stable renal insufficiency or normal renal function.
Renal impairment may flag higher post-PTCA mortality risk; leaves open whether targeted interventions alter survival.
OBJECTIVE: Percutaneous transluminal coronary angioplasty (PTCA) in patients on maintenance hemodialysis leads to high rates of restenosis and postinterventional complications. The additional influence of diabetes mellitus on the results of PTCA in patients with diabetic nephropathy and reduced but sufficient renal function has not been investigated before. METHODS: In a retrospective case-control study, 51 patients with reduced renal function were compared to 71 matched controls. Patients with elevated creatinine values were divided in two subgroups: diabetic nephropathy (diabetes, n = 15) and stable renal insufficiency (renal failure, n = 36). RESULTS: The control group had normal renal function (creatinine: 1.0 +/- 0.01) and a mean survival time of 3.6 +/- 0.8 years. Patients with renal failure showed a mean survival time of 2.7 +/- 0.3 years (p < 0.001), creatinine values of 2.0 +/- 0.2 and elevated fibrinogen values of 401 +/- 28 (p < 0.01). Patients with diabetes (creatinine: 2.2 +/- 0.2) had a significantly higher mortality rate with a reduced mean survival time of 1.25 +/- 0.3 years (p < 0.001), postinterventional acute renal failure (n = 2, p < 0.01) and Re-PTCA (n = 2, p < 0.05). DISCUSSION: Patients with reduced but stable renal function showed a higher mortality than comparable patients from the control group. The group of patients with diabetic nephropathy has a poor prognosis after PTCA even though renal function was only moderately reduced.
No takes yet. Share an insight, caveat, or question.
Matzkies et al. (2001) conducted a case-control in Chronic renal failure with and without diabetic nephropathy undergoing PTCA (n=122). Reduced renal function (diabetic nephropathy or stable renal insufficiency) vs. Normal renal function was evaluated on Mean survival time (p=<0.001). Reduced renal function and diabetic nephropathy in patients undergoing PTCA were associated with lower mean survival times (2.7 and 1.25 years, respectively) compared to controls (3.6 years; p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: