title: Moderate-severe renal insufficiency is a risk factor for sirolimus-eluting stent thrombosis. The RIFT study.
abstract: OBJECTIVE
  The RIFT study aimed to observe the impact of renal insufficiency (RI) on the incidence of stent thrombosis (ST) after percutaneous coronary intervention.
  
  
  METHODS
  The RIFT study enrolled 1,174 patients undergoing revascularization exclusively with sirolimus-eluting stents. The occurrence of ST and major adverse cardiac events were compared between patients with (n = 309) and without (n = 865) RI, and independent predictors of ST were also identified.
  
  
  RESULTS
  During follow-up (mean 18.9 +/- 9.2 months), the rate of ST was significantly higher in patients with than without RI [5.5% (n = 17) vs. 1.7% (n = 15), p < 0.001], and the presence of severe RI (estimated glomerular filtration rate <30 ml/min.1.73 m(2)) was an independent predictor of ST (odds ratio = 4.5, 95% confidence interval 1.4-15, p = 0.011). In patients with RI and diabetes or left ventricular ejection fraction (LVEF) <50%, the incidence of ST was significantly increased [13.0% (n = 10) vs. 3.6% (n = 7), p = 0.010; 11.6% (n = 8) vs. 1.9% (n = 3), p = 0.004, respectively] compared to those with diabetes or LVEF <50% alone. The influence of RI on ST was not significant in patients with multivessel disease, calcified or bifurcation lesions, and target lesion revascularization.
  
  
  CONCLUSIONS
  These findings substantiate the importance of long-term antiplatelet therapy for patients with RI after drug-eluting stent implantation.
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Jiaotong University School of Medicine, Shanghai, PR China.
authors.forename: Zheng Bin
authors.initials: ZB
authors.lastname: Zhu
authors.forename: Rui Yan
authors.initials: RY
authors.lastname: Zhang
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Jian Sheng
authors.initials: JS
authors.lastname: Zhang
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.forename: Zhen Kun
authors.initials: ZK
authors.lastname: Yang
authors.forename: Wei Feng
authors.initials: WF
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000628:therapy; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011237:Predictive Value of Tests; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D020123:Sirolimus / Q000008:administration & dosage*; D013927:Thrombosis / Q000453:epidemiology* / Q000517:prevention & control
chemical_list: D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus