Diabetes mellitus adversely influences the outcome of acute coronary syndrome. This study evaluated the in-hospital outcome of acute coronary syndrome in patients with diabetes mellitus. In this prospective observation study 130 patients with acute coronary syndrome were enrolled. They were divided into diabetic and nondiabetic group. Diabetic patients were taken as case and nondiabetic patients as control. Outcome parameter studied were in-hospital mortality, cardiogenic shock, congestive heart failure, different arrhythmias and recurrent angina. In this study, one third (32%) of the patients were diabetic with mean age 58±10.0 years vs. 53.0±13.6 years in diabetic and nondiabetic group, respectively. Majority of the patients in both groups were male. Congestive heart failure and arrhythmias were more common in case group compared to those in control group (19% vs. 13.6% p=0.424; 23.8% vs. 13.6%, p= 0.148, respectively). Cardiogenic shock developed in 7.1% of diabetic patients and 8% of nondiabetic patients. In hospital mortality was 7.1% and 5.7% in diabetic and nondiabetic group, respectively. Recurrent angina developed only in diabetic patients. Therefore, diabetic patients with acute coronary syndrome encountered more in- hospital adverse outcome. doi: 10.3329/uhj.v5i1.3437 University Heart Journal Vol. 5, No. 1, January 2009 24-27
Contrast-induced nephropathy (CIN) is a recognized complication after percutaneous interventions (PCI). We sought to determine the impact of gender on incidence of CIN. Of a total 200 patients who underwent PCI, there were 33 (16.5%) who developed CIN (defined as > 25% rise in creatinine after PCI). CIN was present in 23.6% of female versus 17.4% of male patients (p < 0.0001). Multivariate analysis showed that female gender (p < 0.0001), pre-PCI chronic renal failure (CRF) (OR= 1.8, 95% CI = 1.53a€"2.10, p < 0.0001), diabetes mellitus (OR = 1.5, 95%, p < 0.0001), age (OR = 1.01, p < 0.0001), and hypertension (OR = 1.2, p = 0.0035) were independent predictors of CIN. By multivariate analysis only baseline CRF, diabetes, age, functional NYHA IV class were identified as independent risk factor for CIN. Female gender is an independent predictor of CIN development.
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