Prognostic factors of coronary heart disease in asymptomatic diabetics for inclusion on the kidney transplant waiting list. Screening with coronary angiography.
OBJECTIVE
Coronary artery disease is a major cause of morbidity and mortality in diabetic kidney transplant candidates. The high prevalence of coronary disease in asymptomatic patients creates the need for major coronary artery disease screening. Our goal was to determine the prevalence and prognostic factors associated with coronary disease in this patient group.


METHODS
A retrospective study of a cohort of 36 asymptomatic patients with diabetes mellitus type 1 and 2 and chronic renal failure that were candidates for renal transplantation between January 2007 and October 2011.


RESULTS
We followed a cohort of 36 patients. Significant coronary disease was found in 65% (13) of patients with type 1 diabetes mellitus and 81.3% (13) with type 2 diabetes mellitus. In the multivariate logistic regression analysis, smoking (OR=8.3, P=.048) and glycosylated haemoglobin levels (OR=9.525, P=.006) were significantly associated with coronary artery disease. Factors not significantly associated with coronary artery disease included: age, sex, type of diabetes mellitus, duration of diabetes mellitus (years) and hypertension.


CONCLUSIONS
Diabetic patients without clinical angina and chronic renal failure who were candidates for inclusion in the kidney transplant waiting list have a high prevalence of significant coronary artery disease. Smoking and glycosylated haemoglobin levels were independently associated with the presence of coronary artery disease.
Servicio de Cardiología, Hospital General de Ciudad Real, Calle del Obispo Rafael Torija, 13005 Ciudad Real, Spain. nati_pinilla@hotmail.com
Natalia
N
Pinilla-Echeverri
Alvaro L
AL
Moreno-Reig
Ana M
AM
Romera-Segorbe
Elisa
E
Pereira
Vicente
V
Fernández-Vallejo
Ignacio
I
Sánchez
Fernando
F
Lozano
Maria T
MT
López
Manuel
M
Marina
Isabel
I
Ferreras
D000328:Adult; D000368:Aged; D058070:Asymptomatic Diseases / Q000453:epidemiology; D008078:Cholesterol, LDL / Q000097:blood; D015897:Comorbidity; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003922:Diabetes Mellitus, Type 1 / Q000453:epidemiology*; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D003928:Diabetic Nephropathies / Q000453:epidemiology; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D015995:Prevalence; D011379:Prognosis; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D014850:Waiting Lists
D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin