Impact of chronic kidney disease and diabetes on percutaneous coronary intervention outcomes.
Abnormalities of glucose metabolism and chronic kidney disease (CKD) complicate treatment and outcomes for patients undergoing percutaneous coronary intervention (PCI). Likely causes of the complicating effects of diabetes include hyperglycemia, abnormalities of microvascular perfusion, and a prothrombotic and proinflammatory state. CKD predisposes to atherosclerosis, adds to the mortality and morbidity risk of cardiovascular disease (CVD), and increases risks for patients undergoing PCI. The complexity of the renal dysmetabolic syndrome and its close association with CVD must be taken into account when developing a therapeutic plan for these patients. Clinical data support the use of abciximab for patients with disturbances of glucose metabolism or with CKD who are undergoing PCI. The use of drug-eluting stents reduces the rate of target vessel revascularization and restenosis.
Lepor
Norman E
NE
David Geffen School of Medicine at UCLA, Cedars-Sinai Medical Center, Los Angeles, California, USA.
D000077284:Abciximab; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D002986:Clinical Trials as Topic; D000077144:Clopidogrel; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D048909:Diabetes Complications / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy*; D054855:Drug-Eluting Stents; D005947:Glucose / Q000378:metabolism; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D017410:Practice Guidelines as Topic; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000188:drug therapy / Q000378:metabolism / Q000628:therapy; D018570:Risk Assessment; D012307:Risk Factors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D005947:Glucose; D013988:Ticlopidine; D000077284:Abciximab