Evaluating the Differential Risk of Contrast-Induced Nephropathy Among Diabetic and Non-diabetic Patients Following Percutaneous Coronary Intervention

Abstract

Background Contrast-induced nephropathy (CIN) significantly complicates percutaneous coronary intervention (PCI), with a higher prevalence in diabetic patients. This study compares the incidence of CIN in diabetic and non-diabetic patients undergoing PCI. Material and methods Conducted at Lady Reading Hospital, Peshawar, PAK, from January to December 2023, this observational study involved 450 adult patients with coronary artery disease (CAD) undergoing PCI. The cohort was categorized based on diabetes status, excluding patients with chronic kidney disease and those on renal replacement therapy. Baseline characteristics documented included age, gender, blood pressure, creatinine levels, and the presence of acute coronary syndrome (ACS). CIN was defined as a ≥25% increase in serum creatinine from baseline within 48-72 hours post-PCI. Data analysis was performed using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY), incorporating descriptive statistics, Chi-square tests, and independent t-tests, with a significance level of p<0.05. Results The median age of the study population was 55 years. The cohort comprised 52% male (n=234) and 48% female (n=216). Notably, 33% (n=149) had ACS. Diabetic patients exhibited a significantly higher incidence of CIN post-PCI compared to non-diabetics. The highest incidence of CIN (17%, n=77) occurred in the 70+ age group. The findings highlight the criticality of renal function monitoring and procedural adjustments for diabetic patients. Conclusion Diabetic patients demonstrate an increased risk of CIN following PCI. This necessitates the development of tailored prevention strategies for this high-risk subgroup.

Percutaneous Coronary Interventions with Sirolimus-Eluting Alex Plus Stents in Patients with or without Diabetes: 4-Year Results

“…Furthermore, managing DM patients undergoing PCI involves a multidisciplinary approach, with close collaboration between cardiologists, endocrinologists, and other healthcare providers [ 10 ]. Optimal glycemic control, along with aggressive management of other cardiovascular risk factors such as hypertension and dyslipidemia, plays a crucial role in improving outcomes post-PCI [ 6 , 11 ].…”

“…Moreover, the duration of dual antiplatelet therapy (DAPT) may be extended in DM patients to minimize the risk of stent thrombosis, or more potent antiplatelet drugs might be used, such as ticagrelor [9]. Furthermore, managing DM patients undergoing PCI involves a multidisciplinary approach, with close collaboration between cardiologists, endocrinologists, and other healthcare providers [10]. Optimal glycemic control, along with aggressive management of other cardiovascular risk factors such as hypertension and dyslipidemia, plays a crucial role in improving outcomes post-PCI [6,11].…”