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Background The influence of albuinuria on clinical outcomes in patients with type 2 diabetes mellitus (T2DM) after elective percutaneous coronary intervention(PCI) with drug-eluting stent (DES) implantation remains unclear.Methods We observed 386 patients with T2DM after elective PCI.The patients were stratified based on the early moing urinary albumin:negative (n =309),trace (urine dipstick trace,n =39),and positive group (urine dipstick ≥1 +,n =38).Kaplan-Meier curve analysis was used to compare the cumulative rates of clinical outcomes (all-cause death,cardiovascular death,MACEs:cardiovascular death,non-fatal myocardial infarction,stroke or revascularization).Cox regression was performed to assess the risk factors for all-cause death and cardiovascular death.Results Median follow-up was 25 months (IQR:17-37 months).Twenty eight (7.3%,13 in the negative group,3 in the trace group and 12 in the positive group) patients died during the entire study period,2 of them (0.7%,1 in the negative group and 1 in the trace group)died during index hospitalization.Positive albuminuria group suffered more contrast-induced acute kidney injury (CI-AKI) and dialysis during hospitalization.The cumulative all-cause death (34.5% vs.8.9% vs.4.9%,P Negative vs.Trace =0.333,P Negative vs.Positive < 0.001,P Trace vs.Positive =0.013,log-rank P < 0.001) and cardiovascular death (29.5% vs.7.4% vs.3.4%,P Negative vs.Trace =0.458,PNegative vs.Positive < 0.001,P Trace vs.Positive =0.014,log-rank P < 0.001) were highest in the positive group.MACE also tends to increase in positive group.After adjusting for potential confounding risk factors,positive albuminuria was still related to all-cause death (HR =5.13,95% CI:2.21-11.89,P < 0.001) and cardiovascular death (HR =5.40,95% CI:2.07-14.09,P =0.001).Conclusion Preprocedural albuminuria predicts poor clinical outcomes,including all-cause death and cardiovascular death,in T2DM patients after elective PCI with DES implantation.