Elective percutaneous coronary intervention for patients with acute coronary syndrome complicated by diabetic nephropathy: a clinical study

Kang Yuqi; Liu Ban

doi:10.3969/j.issn.1674-4055.2017.12.20

Abstract：Objective To study the safety and effectiveness of elective percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) complicated by diabetic nephropathy (DN).Methods There were totally 80 patients with ACS complicated by DN chosen, and then they were divided randomly into control group and observation group (eachn=40). The control group was received emergency PCI and observation group, elective PCI. After followed up for 6 months, the levels of left ventricular end-diastolic inner diameter (LVEDd), left ventricular ejection fraction (LVEF) and N-terminal pro-brain natriuretic peptide (NT-proBNP), incidence of major adverse cardiovascular events (MACE), levels of fasting blood glucose (FBG), serum creatinine (SCr) and 24-h urine protein (UP) quantification, incidence of contrast-induced nephropathy (CIN), maximum platelet aggregation rate (MPAR), and levels of serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and Toll like receptor-4 (TLR-4) were compared between 2 group.Results The difference in number of target vessels, rate of lumen diameter stenosis and number and average length of stent implantation had no statistical significance between 2 groups (P>0.05), and comparison in heart function indexes had no difference between 2 groups (P>0.05). The incidence of MACE and CIN was significantly lower and MPAR was higher in observation group than those in control group (P<0.05). The levels of FBG, SCr and 24-h UP quantification were significantly lower in observation group than those in control group before and after PCI (P<0.05). The levels of IL-6, TNF-α and TLR-4 were significantly lower in observation group than those in control group before and after PCI (P<0.05).Conclusion Elective PCI has higher safety and effectiveness in patients with complicated by DN, and its can reduce incidence of MACE and CIN, improve blood sugar and kidney function, and decrease systemic inflammatory responses.