The Prognostic Significance of Diabetic Nephropathy in Patients Undergoing Coronary Angiography

Background: We hypothesized that diabetic nephropathy will negatively influence outcomes in patients undergoing coronary angiography.

Methods: An observational prospective study of consecutive 424 patients undergoing coronary angiography. The mean follow up was 871 days. Group I patients with GFR≥60 ml/min (219(51.7%)) and group II with GFR

Results: Patients in group II were older, had more PVD and higher CHA₂DS₂VASC score. There was no difference between group I and II in rates of hypertension, atrial fibrillation, MI, previous PCI and CHF. There was no difference in the rates of ACS, PCI performed, LVEF and antiendothelial cell antibodies or troponin I levels between the 2 groups. Patients in group II had significantly higher total (25.4% vs 9.1%, p<0.0001) and early (1 year) mortality (12.7% vs 3.7%, p<0.0001).

Kaplan Meier analysis demonstrated significant association between decreased GFR and total and early mortality (p2DS₂VASC score ≥4, presence of AF, EF<50%; GFR

Conclusion: Reduced GFR is associated with over two fold higher mortality in patients undergoing coronary angiography. Advanced aged mitigates the effect of renal insufficiency on mortality.