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Residual Syntax score and percutaneous coronary intervention in diabetic patients with renal insufficiency
Minjian Peng1,2, Tao Ye3, Kai Lan3
1Department of Cardiology, The Affiliated Hospital of Southwest Medical University Luzhou 646000, Sichuan, China.
Insights
The residual Syntax score (rSS) is linked to poorer long-term outcomes in diabetic patients with kidney insufficiency after percutaneous coronary intervention (PCI). Higher rSS indicates incomplete revascularization and is associated with adverse events.
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Interventional Cardiology
Background:
- Diabetic patients with renal insufficiency represent a high-risk population undergoing percutaneous coronary intervention (PCI).
- Assessing long-term prognosis in this cohort is crucial for guiding treatment strategies.
- The residual SYNTAX score (rSS) quantifies the complexity of remaining coronary lesions after PCI.
Purpose of the Study:
- To investigate the correlation between the residual SYNTAX score (rSS) and the long-term prognosis of diabetic patients with renal insufficiency following PCI.
- To identify independent risk factors influencing long-term outcomes in this patient group.
Main Methods:
- Retrospective study of 510 patients with coronary heart disease, diabetes, and renal insufficiency who underwent PCI.
- Patients categorized into three groups based on estimated glomerular filtration rate (eGFR).
- Revascularization assessed by rSS (rSS > 8 indicating incomplete revascularization); 12-month follow-up for major adverse cardiovascular events (MACE).
Main Results:
- Univariate analysis revealed myocardial infarction (MI), β-blocker use, and follow-up duration significantly impacted prognosis.
- MI, β-blocker use, and follow-up duration were identified as independent risk factors for long-term prognosis.
- rSS showed positive correlations with blood glucose, uric acid, urea, serum creatinine, and eGFR, and was positively correlated with long-term prognosis.
Conclusions:
- The residual SYNTAX score (rSS) is a valuable tool for assessing incomplete revascularization in diabetic patients with renal insufficiency post-PCI.
- rSS, MI, β-blocker use, and follow-up duration are positively correlated with adverse long-term prognosis in this high-risk population.
Objective:
To investigate the correlation between residual Syntax score (rSS) and long-term prognosis in diabetic patients with renal insufficiency undergoing percutaneous coronary intervention (PCI).
Methods:
In this retrospective study, we included 510 patients with coronary heart disease, diabetes, and renal insufficiency who received PCI at the Third People's Hospital of Chengdu from July 2018 to December 2020. Patients were divided into three groups based on their eGFR levels: 113 patients with eGFR ≥ 60 mL/min/1.73 m2, 256 patients with eGFR between 30 and 60 mL/min/1.73 m2, and 141 patients with eGFR < 30 mL/min/1.73 m2. Revascularization was quantified using the residual SYNTAX score (rSS), with an rSS > 8 indicating incomplete revascularization. We collected baseline data on cardiovascular adverse events and followed up with patients for 12 months, analyzing the correlations between rSS and biochemical markers such as blood glucose, uric acid, urea, serum creatinine, and eGFR, as well as the relationship between major adverse cardiovascular events (MACE) and rSS.
Results:
Univariate analysis identified myocardial infarction (MI), β-blocker use, and follow-up duration as factors significantly associated with the long-term prognosis of diabetic patients with renal insufficiency after PCI (P < 0.05). MI (OR=3.053, P=0.009), β-blocker use (OR=3.134, P=0.009), and follow-up duration (OR=0.998, P=0.05) were independent risk factors for long-term prognosis in these patients. rSS was positively correlated with blood glucose (r=0.973, P=0.000), uric acid (r=0.933, P=0.000), urea (r=0.907, P=0.000), serum creatinine (r=0.588, P=0.000), and eGFR (r=0.623, P=0.000). Syntax score was also positively correlated with long-term prognosis (OR=0.138, P=0.001).
Conclusion:
The rSS is a valuable tool for evaluating independent risk factors such as incomplete revascularization, MI, β-blocker use, and follow-up duration, all of which are positively correlated with the long-term prognosis of diabetic patients with renal insufficiency after PCI.
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