Abstract 1693: The Impact of Percutaneous Coronary Intervention on Renal Function in Diabetic Patients With Normal Baseline Serum Creatinine
Background: Diabetics are prone to contrast nephropathy. The outcome of diabetics with normal baseline serum creatinine (SCr) undergoing PCI remains under-evaluated. The present study aims to assess the incidence, outcome, and correlates of SCr rise post-PCI in this subset.
Methods: The study cohort consisted of 570 consecutive diabetic patients with normal SCr (≤1.3mg/dl) who underwent non-emergent PCI. Patients presenting with AMI, shock, and age >75 years were excluded. SCr rise was defined as ≥25% rise from baseline. Study endpoints were post-PCI SCr rise and major adverse cardiac events (MACE) at 6 months. Logistic regression was performed to identify predictors of SCr rise.
Results: SCr rise occurred in 70 patients (incidence=12.3%). Patients with SCr rise were more likely to be female (55.7% vs. 35.5% p = 0.001) and have a history of congestive heart failure (24.2% vs. 14.7% p=0.048). Patients with SCr rise had greater entry site complications (hematoma, pseudoaneurysm) and need for blood transfusion (16.7% vs.1.7% p<0.001). In-hospital mortality (8.6% vs. 0.2% p<0.001) and length of stay (4.51±5.2 vs. 2.23±2.9 days p<0.001) were significantly higher in patients with SCr rise. No study patient required dialysis. At 6 months, MACE was markedly higher in patients with SCr rise (21.4% vs. 6.0% p<0.001) driven by death and revascularization. Independent predictors of SCr rise were female gender, blood transfusion, and lower body mass index.
Conclusions: Post-PCI rise in SCr in diabetics with normal baseline values is common and is a marker of late adverse cardiac events. Greater emphasis needs to be placed on prevention and monitoring of rises in SCr in the diabetic population.