Impact of drug-eluting stents on clinical and angiographic outcomes in dialysis patients.
BACKGROUND
It remains unclear whether sirolimus-eluting stents (SES) have an advantage over bare metal stents (BMS) in patients on dialysis.


RESULTS
Percutaneous coronary intervention (PCI) using SES was performed in 54 dialysis patients with 69 lesions. A control group for comparison comprised 54 consecutive dialysis patients with 58 lesions who underwent PCI using BMS. Angiographic and clinical follow-ups were scheduled at 9 months. After the procedure, minimum lumen diameter (MLD) was similar between the 2 groups. At follow-up, the SES group had a higher MLD than the BMS group (1.98+/-0.83 mm vs 1.50+/-0.78 mm, p<0.01). In-stent restenosis rate was lower in lesions treated with SES than in those with BMS (22% vs 40%, p=0.048). However, there was no significant difference between the 2 groups for in-segment restenosis (31% vs 43%, p=0.3). During follow-up, there was no significant difference in the incidence of death, myocardial infarction or target lesion revascularization (TLR) (14% vs 21%, p=0.4) between the SES and BMS groups.


CONCLUSIONS
In this retrospective study, SES, in comparison with BMS, reduced in-stent restenosis in patients on dialysis. However, in-segment restenosis and TLR were not statistically different between lesions treated with SES and those with BMS.
Ishio
Naoki
N
Department of Cardiovascular Science and Medicine, Chiba University Graduate School of Medicine, Chiba, Japan.
Kobayashi
Yoshio
Y
Takebayashi
Hideo
H
Iijima
Yoshihiro
Y
Kanda
Junji
J
Nakayama
Takashi
T
Kuroda
Nakabumi
N
De Gregorio
Joseph
J
Kouno
Yukinori
Y
Suzuki
Masaru
M
Haruta
Seiichi
S
Komuro
Issei
I
D054058:Acute Coronary Syndrome / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods*; D016022:Case-Control Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis; D003331:Coronary Vessels / Q000503:physiopathology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007676:Kidney Failure, Chronic / Q000150:complications / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow / Q000502:physiology; D006435:Renal Dialysis; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents; D016896:Treatment Outcome; D014661:Vasoconstriction / Q000502:physiology
D007166:Immunosuppressive Agents; D020123:Sirolimus