title: Associations between lipid profiles and MACE in hemodialysis patients with percutaneous coronary intervention: from the FU-Registry.
abstract: BACKGROUND
  It is well known that percutaneous coronary intervention (PCI) in hemodialysis (HD) patients is associated with higher rates of in-stent restenosis and major adverse cardiovascular events (MACE) compared to that in non-HD patients, even if the target value in cholesterol management is achieved.
  
  
  METHODS
  To evaluate the factors that are associated with MACE in HD patients, we selected 142 HD patients (164 lesions) without acute coronary syndrome (ACS) from 2148 patients (2568 lesions) who underwent PCI in our database of the FU-Registry [UMIN000005679, Fukuoka University Hospital EC/IRB:10-1-08(09-105)], and compared 52 patients (53 lesions) with MACE [MACE(+)] to 90 patients (111 lesions) without MACE [MACE(-)].
  
  
  RESULTS
  Total cholesterol (TC: 150±30mg/dL vs 166±39mg/dL, p<0.05) and high-density lipoprotein cholesterol (HDL-C: 40.1±14.7mg/dL vs 47.8±13.5mg/dL, p<0.01) levels were significantly lower in the MACE(+) group at follow-up. No significant differences were observed in other parameters, including triglyceride, low-density lipoprotein cholesterol (LDL-C; LDL-C/HDL-C ratio, and % changes in HDL-C, non-HDL-C, LDL-C), and hemoglobin A1c (US National Glycohemoglobin Standardization Program) between before and after PCI. TC, LDL-C, and non-HDL-C at the time of PCI and TC, and HDL-C at the 9-month follow-up were negatively correlated with MACE, while body mass index (BMI) [odds ratio (OR): 0.81; 95% confidence interval (CI): 0.68-0.95)], prior coronary artery bypass graft (CABG) (OR: 3.89; 95%CI: 1.29-12.6), and insulin use (OR: 3.17; 95%CI: 1.23-8.55) were strongly correlated with MACE in a multivariate analysis.
  
  
  CONCLUSIONS
  BMI, CABG, and insulin use, but not LDL-C, are independent predictors of MACE in HD patients, suggesting that the application of lipid management for non-HD patients to HD patients at the time of PCI may not necessarily be beneficial for medium-term clinical outcomes.
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Itsuki
authors.initials: I
authors.lastname: Nagata
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan. Electronic address: ikeamane@yahoo.co.jp.
authors.forename: Amane
authors.initials: A
authors.lastname: Ike
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nishikawa
authors.affiliation: Department of Biochemistry, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Sugihara
authors.affiliation: Department of Cardiology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Mori
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iwata
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawamura
authors.affiliation: Division of Cardiology, Hakujyuji Hospital, Fukuoka, Japan.
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shirai
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Uehara
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ogawa
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan.
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Miura
authors.affiliation: Department of Cardiology, Fukuoka University School of Medicine, Fukuoka, Japan. Electronic address: saku-k@fukuoka-u.ac.jp.
authors.forename: Keijiro
authors.initials: K
authors.lastname: Saku
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D023903:Coronary Restenosis / Q000517:prevention & control; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007564:Japan; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D012042:Registries; D006435:Renal Dialysis / Q000009:adverse effects*; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D008055:Lipids; D014280:Triglycerides; C517652:hemoglobin A1c protein, human
keywords: Hemodialysis; Lipoprotein; MACE; PCI; Registry