Moderate-severe renal insufficiency is a risk factor for sirolimus-eluting stent thrombosis. The RIFT study.
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.
Zhu
Zheng Bin
ZB
Department of Cardiology, Rui Jin Hospital, Jiaotong University School of Medicine, Shanghai, PR China.
Zhang
Rui Yan
RY
Zhang
Qi
Q
Zhang
Jian Sheng
JS
Hu
Jian
J
Yang
Zhen Kun
ZK
Shen
Wei Feng
WF
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
D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus