title: Hemodialysis is an independent predictor of coronary in-stent restenosis after paclitaxel eluting stent implantation.
abstract: OBJECTIVE
  A drug eluting stent is often used for high-risk patients with complications such as diabetes mellitus (DM) and hemodialysis (HD), however the factors to predict restenosis after paclitaxel-eluting stent (PES) placement have not been reported to date.
  
  
  METHODS
  Between May 2007 and August 2009, 165 consecutive patients (231 stents) received PES in our hospital. Stent diameter and length were determined by the use of intravascular ultrasound (IVUS). All patients continued to take 2 types of anti-platelet agents (aspirin and Clopidogrel or Ticlopidine). Ninety percent of the subjects received a follow-up coronary angiogram 6 months later.
  
  
  RESULTS
  Underlying diseases were hypertension in 75%, hyperlipidemia in 78% and DM in 60% (15% on insulin), and 14% of the subjects received HD. Eighty-three percent of the patients had orally taken Statin, 85% ACE/ARB and 68% had beta blockers. Mean length and diameter of PES were 21.6 ± 7.2 mm and 2.9 ± 0.3 mm, respectively. Target lesion revascularization (TLR) rate 6 months after PES placement was 14.6% overall. In HD patients TLR was 43%, hypertension 15.0%, hyperlipemia 12.4%, DM with oral medication 12.5%, DM with insulin 12.0%, respectively. In multivariate analysis, HD was an independent risk factor for TLR (p=0.0001, OR: 6.61, 95% C.I.: 2.34-18.6).
  
  
  CONCLUSIONS
  HD had the greatest influence on TLR after PES even though risk factors were well controlled. It is necessary to develop new PCI techniques and stents that are useful for HD patients.
authors.affiliation: Department of Cardio-Angiology, Kitasato University School of Medicine, Sagamihara, Japan. itake@myad.jp
authors.forename: Ichiro
authors.initials: I
authors.lastname: Takeuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Moriguchi
authors.forename: Ryuta
authors.initials: R
authors.lastname: Imaki
authors.forename: Hidehira
authors.initials: H
authors.lastname: Fukaya
authors.forename: Hisahito
authors.initials: H
authors.lastname: Shinagawa
authors.forename: Takao
authors.initials: T
authors.lastname: Shimohama
authors.forename: Taiki
authors.initials: T
authors.lastname: Tojo
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukuda
authors.forename: Takayuki
authors.initials: T
authors.lastname: Inomata
authors.forename: Naoyoshi
authors.initials: N
authors.lastname: Aoyama
authors.forename: Kazui
authors.initials: K
authors.lastname: Soma
authors.forename: Tohru
authors.initials: T
authors.lastname: Izumi
mesh_terms: D000368:Aged; D023903:Coronary Restenosis / Q000453:epidemiology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage*; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D017239:Paclitaxel