ABSTRACT
Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention [PCI]. The prognosis of patients with diabetes mellitus and chronic total occlusion [CTO] treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15 +/- 3 months, were evaluated for the occurrence of major adverse cardiac events [MACE] comprising death, acute myocardial infarction, and need for repeat revascularization. No differences were found in baseline clinical and procedural variables between patients with [n=34] and without diabetes [n=129], unless for hypertension [p=0.03]. Hospitalization period after PCI in diabetics [3.26+0.61 days] and non-diabetics[2.86+0.52 days] was similar. In-hospital MACE occurred in 8 [23.5%] individuals of diabetics and 10 [7.8%]individuals of non-diabetics [p=0.02] among them revascularization was significantly higher in diabetics [20.6% vs. 7%, p=0.04]. Follow-up events in diabetic and non-diabetic groups were 12 [35.3%] and 37 [28.5%], respectively [p was not significant]. In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients
ABSTRACT
Renal failure predisposes patients to adverse outcome after coronary artery bypass grafting [CABG] Renal dysfunction is a predictor of increased morbidity and mortality after CABG, whether it is dialysis-dependent or not. In a retrospective study from April 2000 to December 2010, seventy-six patients [60 male and 16 female with the mean age of 58.57+7.93 years] with different categories of chronic renal failure undergoing CABG in Shahid Madani Hospital, were studied. The cardiac disease leading to the operation was coronary artery disease [CAD] in all patients. Patients demographic, surgical and laboratory data were gathered from hospital records. Data were then analyzed. Mean hospital stay was 10.16+7.16 days. The preoperative mortality rate was 10.5% [15% in non dialysis and 5.6% in dialysis dependant patients with no significant difference]. Morbidity rate was 28.9% [respectively 30% and 27.8% in dialysis and non dialysis patients with no significant difference] including in-hospital myocardial infarction [MI] [10.5%], in-hospital stroke [2.6%], in-hospital bleeding [21.1%] and in-hospital infection, pneumonia, [5.3%]. Mean creatinine and blood urea nitrogen [BUN] levels were significantly increased after surgery [p0.001]. Postoperative hemodialysis rate was 33.3%. Chronic renal failure whether dialysis-dependant or not increases in-hospital mortality and morbidity in patients undergoing CABG. For CRF patients not on dialysis with a creatinine 2.5 gm/dL, there is a strong likelihood of postoperative dialysis