Abstract | BACKGROUND: METHODS: A total of 675 lesions of 593 patients treated with SES were analyzed. Patients were classified into 3 groups: 34 patients on HD; 337 patients with estimated glomerular filtration rate > or =60 mL min(-1) 1.73 m(-2) (non-CKD group); and 222 patients who had lower estimated glomerular filtration rate <60 mL min(-1) 1.73 m(-2) without HD dependency (CKD group). RESULTS: At angiographic follow-up (201 +/- 73 days), in-segment late loss was markedly higher in the HD group versus the non-CKD and CKD groups (0.68 +/- 1.06 vs 0.11 +/- 0.45 and 0.15 +/- 0.50 mm, respectively, P < .001), resulting in a significantly higher in-segment restenosis rate (40.0% vs 10.4% and 11.5%, respectively, P < .001). At 2 years, HD vs non-CKD and CKD was associated with a significantly higher MACE rate (35.3% vs 10.4% and 12.6%, respectively, P < .001), mainly driven by significantly higher mortality (11.8% vs 0.6% and 2.3%, respectively, P < .001) and target-lesion revascularization (23.5% vs 9.2% and 8.1%, respectively, P = .016) rates. Multivariable analysis revealed that HD was the independent predictor of 2-year MACE (hazard ratio 4.70, 95% CI 2.40-9.20, P < .001). CONCLUSIONS: Although angiographic and clinical outcomes after SES implantation were similarly favorable in non-HD-dependent CKD patients, regardless of renal function, in patients with end-stage CKD requiring HD, frequencies of restenosis and 2-year MACE were markedly higher than in non-HD-dependent patients.
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Authors | Tomoyuki Ota, Hisashi Umeda, Shigeki Yokota, Shinjiro Miyata, Atsushi Takamura, Shigeo Sugino, Kazutaka Hayashi, Ryoji Ishiki, Yasushi Takeichi, Mitsunori Iwase, Haruo Inagaki, Toyoaki Murohara |
Journal | American heart journal
(Am Heart J)
Vol. 158
Issue 1
Pg. 92-8
(Jul 2009)
ISSN: 1097-6744 [Electronic] United States |
PMID | 19540397
(Publication Type: Comparative Study, Journal Article)
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Chemical References |
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
- Cause of Death
- Comorbidity
- Coronary Angiography
- Coronary Restenosis
(etiology, mortality)
- Disease-Free Survival
- Drug-Eluting Stents
- Equipment Failure Analysis
- Female
- Follow-Up Studies
- Glomerular Filtration Rate
(physiology)
- Humans
- Kaplan-Meier Estimate
- Kidney Failure, Chronic
(complications, diagnosis, mortality, therapy)
- Male
- Middle Aged
- Multivariate Analysis
- Myocardial Infarction
(diagnosis, mortality, therapy)
- Proportional Hazards Models
- Renal Dialysis
- Risk Factors
- Sirolimus
(administration & dosage)
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