Department of Cardiovascular Diseases, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Vascular and Endovascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Physiol Rep. 2024 Aug;12(15):e16180. doi: 10.14814/phy2.16180.
The objective of the present investigation was to compare the coronary angiography results in diabetic patients with and without end-stage kidney disease (ESKD). We included prolonged diabetic patients with ESKD (93 patients) and without ESKD (control group, 126 patients). Angiography of the coronary arteries was performed on all patients. Our results revealed that the ESKD patients tended to have a higher degree of coronary artery stenosis in all parts of LAD (p = 0.001, 0.024, and 0.005), proximal and distal RCA (p = 0.013, and 0.008), and proximal and distal LCX artery (p = 0.001, 0.008) than non-ESKD patients. Furthermore, we found that the ESKD group had higher significant coronary artery stenosis in the LAD artery (60.5% vs. 39.5%, p < 0.001), RCA (60.3% vs. 39.7%, p < 0.001), LCX artery (79.5% vs. 20.5%, p < 0.001), and LMCA (84.6% vs 15.4%, p = 0.002) compared to control group. There was a greater prevalence of multiple vessels coronary artery disease (≥ two) among ESKD patients (29%), compared with the non-ESKD group (16.8%, p < 0.001). Significant coronary artery stenosis was meaningfully higher in asymptomatic diabetic ESKD patients on hemodialysis than non-ESKD diabetic patients. Coronary angiography may be beneficial in diabetic patients with ESKD regardless of whether they have ischemic symptoms with low complication rate through radial access.
本研究旨在比较伴有和不伴有终末期肾病（ESKD）的糖尿病患者的冠状动脉造影结果。我们纳入了伴有 ESKD（93 例）和不伴有 ESKD（对照组，126 例）的长期糖尿病患者。所有患者均行冠状动脉造影。我们的结果表明，ESKD 患者的 LAD（p=0.001、0.024 和 0.005）、RCA 近端和远端（p=0.013 和 0.008）和 LCX 动脉近端和远端（p=0.001、0.008）的冠状动脉狭窄程度较高。此外，我们发现 ESKD 组的 LAD 动脉（60.5%比 39.5%，p<0.001）、RCA（60.3%比 39.7%，p<0.001）、LCX 动脉（79.5%比 20.5%，p<0.001）和 LMCA（84.6%比 15.4%，p=0.002）的显著冠状动脉狭窄程度高于对照组。ESKD 患者的多支血管病变（≥2 支）发生率（29%）高于非 ESKD 组（16.8%，p<0.001）。与非 ESKD 糖尿病患者相比，无症状性糖尿病 ESKD 患者在血液透析时的显著冠状动脉狭窄程度更高。通过桡动脉入路，即使患者无缺血症状且并发症发生率低，冠状动脉造影对伴有 ESKD 的糖尿病患者也可能有益。
