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- Title
Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population.
- Authors
Jiang Ming Fam; Chun Yuan Khoo; Yee How Lau; Weng Kit Lye; Xinzhe James Cai; Lina Hui Lin Choong; Allen, John Carson; Khung Keong Yeo; Fam, Jiang Ming; Khoo, Chun Yuan; Lau, Yee How; Lye, Weng Kit; Cai, Xinzhe James; Choong, Lina Hui Lin; Yeo, Khung Keong
- Abstract
<bold>Introduction: </bold>There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society.<bold>Methods: </bold>A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years.<bold>Results: </bold>274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE.<bold>Conclusion: </bold>Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.
- Subjects
PERCUTANEOUS coronary intervention; HEMODIALYSIS patients; DIABETES; MYOCARDIAL infarction; TREATMENT effectiveness; AGE; ASIANS; ADVERSE health care events
- Publication
Singapore Medical Journal, 2021, Vol 62, Issue 6, p300
- ISSN
0037-5675
- Publication type
journal article
- DOI
10.11622/smedj.2020025