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Asymptomatic Coronary Artery Disease: Angiography in Diabetic Patients Before Renal Transplantation: Relation of Findings to Postoperative Survival

L. A. WEINRAUCH, M.D.; J. A. D'ELIA, M.D., F.A.C.P.; R. W. HEALY, M.D.; R. E. GLEASON, Ph.D.; F. J. TAKACS, M.D., F.A.C.P.; J. A. LIBERTINO, M.D., F.A.C.S.; and O. S. LELAND Jr., M.D.
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▸Requests for reprints should be addressed to O.S. Leland, Jr., M.D.; Cardiology Section, New England Deaconess Hospital, 185 Pilgrim Road; Boston, MA 02215.

Boston, Massachusetts

© 1978 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1978;88(3):346-348. doi:10.7326/0003-4819-88-3-346
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Twenty-one juvenile-onset diabetic patients with azotemic nephropathy underwent coronary angiography and left ventriculography before renal transplantation or chronic hemodialysis. Two-year survival of 12 patients with no coronary artery disease (group A) was 88% compared to 22% for nine patients with coronary artery disease (group B) (P < 0.025). Each group A patient underwent renal transplantation (nine live-related, three cadaveric). Four group B patients received cadaveric allografts. Among group A patients two cadaveric allografts functioned while in group B patients no allografts were successful. In the absence of coronary artery disease, results were similar to those reported for nondiabetic persons. In the presence of coronary artery disease, 62% of the deaths were due to myocardial infarction or sudden death. These results indicate that atherosclerotic coronary artery disease is a major determinant of survival in diabetic patients undergoing chronic hemodialysis or renal transplantation.





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