Research Paper|Volume 13, Issue 16|pp 20081—20093

Effect of diabetic kidney disease on therapeutic strategies for coronary artery disease: ten year follow-up

Daniel Valente Batista¹, Whady Hueb¹, Eduardo Gomes Lima¹, Paulo Cury Rezende¹, Cibele Larrosa Garzillo¹, Rosa Maria Rahmi Garcia¹, Jaime Paula Pessoa Linhares Filho¹, Eduardo Bello Martins¹, Carlos Vicente Serrano Junior¹, Jose Antonio Franchini Ramires¹, Roberto Kalil Filho¹

¹Instituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, SP, BR.

Received: May 9, 2021Accepted: August 16, 2021Published: August 25, 2021

https://doi.org/10.18632/aging.203476

Copyright: © 2021 Batista et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

Background: The best treatment for coronary artery disease (CAD) in patients with type 2 diabetes (DM2) and chronic kidney disease is unknown.

Methods: This retrospective study included MASS registry patients with DM2 and multivessel CAD, stratified by kidney function. Primary endpoint was combined of mortality, myocardial infarction, or additional revascularization.

Results: Median follow-up was 9.5 years. Primary endpoint occurrences among strata 1 and 2 were 53.4% and 40.7%, respectively (P=.020). Mortality rates were 37.4% and 24.6% in strata 1 and 2, respectively (P<.001). We observed a lower rate of major adverse cardiovascular events (MACE) (P=.027 for stratum 1 and P<.001 for stratum 2) and additional revascularization (P=.001 for stratum 1 and P<.001 for stratum 2) for those in the surgical group. In a multivariate analysis, eGFR was an independent predictor of MACE (P=.034) and mortality (P=.020).

Conclusions: Among subjects with DM2 and CAD the presence of lower eGFR rate was associated with higher rates of MACE and mortality, irrespective of treatment choice. CABG was associated with lower rates of MACE in both renal function strata. eGFR was an independent predictor of MACE and mortality in a 10-year follow-up.