Sirolimus-eluting stents vs bare metal stents for coronary intervention in Japanese patients with renal failure on hemodialysis.
BACKGROUND
Accelerated atherosclerosis is a major risk for long-term survivors receiving hemodialysis (HD), with coronary events being the leading cause of mortality.


RESULTS
A total of 88 consecutive patients on HD (121 lesions) who underwent percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES) were compared with 78 patients on HD (95 lesions) who received bare metal stents (BMS) in the preceding 1 year. The primary endpoint was angiographic restenosis defined as > or =50% diameter stenosis at 6-8 months follow-up after PCI. The angiographic restenosis rate at follow-up was 22.2% in the SES group and 24.4% in the BMS group. No difference was detected in the restenosis rate between the 2 groups (p=0.73). When including both HD and non-HD patients, the independent predictors for restenosis after SES implantation were treatment with HD (hazard ratio (HR) 3.12; 95% confidence interval (CI) 1.23-7.95; p=0.016), incidence of hyperlipidemia (HR 3.93; 95%CI 1.12-13.7; p=0.032), coronary calcification (HR 2.78; 95%CI 1.12-6.91; p=0.027), and implantation of multi-stents (HR 4.14; 95%CI 1.70-10.1; p=0.0017).


CONCLUSIONS
Even if treated with SES, patients with end-stage renal failure on HD are at high risk of restenosis after PCI.
Aoyama
Toru
T
Department of Cardiology, Nagoya Kyoritsu Hospital, Showa-ku, Nagoya, Japan.
Ishii
Hideki
H
Toriyama
Takanobu
T
Takahashi
Hiroshi
H
Kasuga
Hirotake
H
Murakami
Ryuichiro
R
Amano
Tetsuya
T
Uetani
Tadayuki
T
Yasuda
Yoshinari
Y
Yuzawa
Yukio
Y
Maruyama
Shoichi
S
Matsuo
Seiichi
S
Matsubara
Tatsuaki
T
Murohara
Toyoaki
T
D000368:Aged; D002114:Calcinosis; D017023:Coronary Angiography; D003327:Coronary Disease / Q000601:surgery / Q000628:therapy; D023903:Coronary Restenosis; D054855:Drug-Eluting Stents / Q000592:standards*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias; D007564:Japan; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D006435:Renal Dialysis; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents / Q000592:standards*
D020123:Sirolimus