Background: Chronic renal impairment (CRI) is well known risk factor in patients (pts) with coronary artery disease; however impact of CRI in pts with peripheral arterial disease (PAD) is not well defined. We evulate effect of CRI on procedural & clinical outcomes in below the knee (BTK) intervention. Methods: A total 82 consecutive patients with 147 BTK lesions. Study population were divided into 2 groups according to renal funtion.CRI was defined as serum creatinine more than 1.5 mg/dl. Results: Baseline characteristics were similar between 2 groups. Lesions data were also similar except that CRI group had more calcific lesions. Pre procedure diameter stenosis (DS) was more in normal group, while Post procedure (DS) was more in CRI .Post procedure diameter stenosis (DS) was more in CRI. Post procedural ischemic complications and one year clinical follow up were not different; except for wound debridement was more in CRI group. (Table 1) Conclusions: In our study, CRI was not associated with worse angiographic and clinical outcome than pts with normal renal function.
Background: Elevated plasma level of N-Terminal-Pro-B-type Natriuretic Peptide (NT-pro BNP) is known to be associated with significant coronary artery disease.The aim of this study is to evaluate the association between NT-proBNP and long-term clinical outcomes in patients (pts) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). Methods: The study population consisted of 2,121consecutive patients (pts) undergoing PCI enrolled from November 2005 to August 2010. The pts were divided into four groups according to quartiles of NT-proBNP levels: BNP1 (≤ 61.81 pg/mL), BNP2 (61.81 < NT-proBNP ≤197.70 pg/mL), BNP3 (197.70 < NT-proBNP ≤ 990.70pg/mL), BNP4 (> 990.70pg/mL). Results: At baseline, the prevalence of elderly, male gender, hypertension, diabetes mellitus, peripheral artery disease, chronic kidney disease, smoking, and acute myocardial infarction (AMI) were higher in pts with higher NT-proBNP. At baseline, left main, left descending artery (LAD) and right coronary artery (RCA) as for target lesions, diffuse and small vessel disease were higher in pts with higher NT-proBNP. Clinical outcomes up to 2 years showed that cumulative total death, cardiac death, AMI, repeat PCI and total target lesion revascularization (TLR)-major cardiac adverse event (MACE) were higher in pts with higher NT-proBNP. High NT-proBNP was an independent predictor of TLR-MACE (Adjusted OR: 2.6, 95% CI:1.4-4.7, p>0.001). Conclusions: In our study, the prevalence of conventional risk factors of CVD was higher in pts with higher NT-proBNP. Higher NT-proBNP was associated with adverse long term clinical outcomes up to 2 years. We suggest that elevated NT-proBNP would have important and sensitive role in long term clinical outcomes following PCI.
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