One-year clinical outcomes of dialysis patients after implantation with sirolimus-eluting coronary stents.
BACKGROUND
The efficacy of sirolimus-eluting stents (SESs) has not been established in dialysis patients.


RESULTS
This study was a non-randomized observational single-center registry in a community hospital: data for 80 consecutive dialysis patients who underwent percutaneous coronary intervention (PCI) with SES were compared with those of a historical group of consecutive 124 dialysis patients treated with bare-metal stents (BMS). After 1 year, the cumulative incidence of major adverse cardiac events (MACE), comprising cardiac death, nonfatal myocardial infarction, stent thrombosis, or target lesion revascularization (TLR), was 25.2% in the SES group and 38.2% in the BMS group (p=0.048). In multivariate analysis, use of SES remained an independent predictor of MACE at 1 year after PCI (risk ratio 0.70, 95% confidence interval 0.52-0.93, p=0.015). Rates of TLR were 21.7% in the SES group and 30.9% in the BMS group and (p=0.15). Subgroup analysis showed that use of SES was effective in patients with small vessels, non-diabetic patients, and patients without highly calcified lesions.


CONCLUSIONS
In dialysis patients, the implantation of SES was moderately effective in reducing MACE at 1 year after PCI as compared with BMS. However, the TLR rate at 1 year was relatively higher than previously reported.
Okada
Takenori
T
Department of Molecular and Internal Medicine, Graduate School of Biomedical Sciences, Hiroshima University, and Department of Cardiology, Akane-kai, Tsuchiya General Hospital, Hiroshima, Japan.
Hayashi
Yasuhiko
Y
Toyofuku
Mamoru
M
Imazu
Michinori
M
Otsuka
Masaya
M
Sakuma
Tadamichi
T
Ueda
Hironori
H
Yamamoto
Hideya
H
Kohno
Nobuoki
N
D000368:Aged; D006328:Cardiac Catheterization; D054855:Drug-Eluting Stents; D005260:Female; D006331:Heart Diseases / Q000401:mortality / Q000628:therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D020123:Sirolimus / Q000494:pharmacology*; D013997:Time Factors
D007166:Immunosuppressive Agents; D020123:Sirolimus