title: Clinical and angiographic outcomes following percutaneous coronary intervention with sirolimus-eluting stents versus bare-metal stents in hemodialysis patients.
abstract: BACKGROUND
  Percutaneous coronary intervention for hemodialysis patients has been hampered by the high rate of adverse cardiac events. Our aim was to investigate whether sirolimus-eluting stents (SESs) improve clinical outcomes of hemodialysis patients compared with bare-metal stents (BMSs).
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  123 consecutive patients on hemodialysis therapy treated with either an SES or BMS. There were 56 patients with 68 lesions treated with SESs between August 2004 and April 2006 (SES group) and 67 patients with 71 lesions treated with BMSs 4 years before approval of SESs in Japan (BMS group).
  
  
  METHODS
  SES and BMS implantation for hemodialysis patients with coronary artery disease.
  
  
  METHODS
  Follow-up angiography was performed at 6 to 8 months and clinical follow-up was obtained at 9 months after the procedure. Late lumen loss and major adverse cardiac events, including all-cause death, myocardial infarction, and target-lesion revascularization, were investigated.
  
  
  RESULTS
  Clinical follow-up was obtained in all patients. Angiographic follow-up was obtained in 50 patients (89.3%) in the SES group and 50 patients (74.6%) in the BMS group. The SES group had more complex lesions than the BMS group. Quantitative angiographic analysis showed a significant difference for in-stent late lumen loss (SES, 0.62 +/- 0.75 mm; BMS, 1.07 +/- 0.75 mm; P = 0.003). Of angiographic restenosis lesions analyzed, a focal restenotic pattern was observed more frequently in the SES group than the BMS group (SES, 87.5%; BMS, 23.8%; P < 0.001). The rate of major adverse cardiac events was significantly lower in the SES group (n = 14; 25.0%) than the BMS group (n = 26; 38.9%; log-rank P = 0.02).
  
  
  CONCLUSIONS
  Retrospective study design, small sample size, and a single-center study.
  
  
  CONCLUSIONS
  Clinical and angiographic data in the present study suggest that SESs are more effective than BMSs in hemodialysis patients.
authors.affiliation: Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Sen
authors.initials: S
authors.lastname: Yachi
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Shuzou
authors.initials: S
authors.lastname: Tanimoto
authors.forename: Jiro
authors.initials: J
authors.lastname: Aoki
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.forename: Hirosada
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Shuji
authors.initials: S
authors.lastname: Otsuki
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Yagishita
authors.forename: Satoru
authors.initials: S
authors.lastname: Kishi
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakano
authors.forename: Masahiro
authors.initials: M
authors.lastname: Taniwaki
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Naofumi
authors.initials: N
authors.lastname: Mise
authors.forename: Tokuichiro
authors.initials: T
authors.lastname: Sugimoto
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Hara
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D006435:Renal Dialysis; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage*
chemical_list: D020123:Sirolimus