title: Effect of Hemodialysis on 7-Year Clinical Outcomes After Sirolimus-Eluting Stent Implantation.
abstract: BACKGROUND
  Hemodialysis (HD) patients are reported to show poor clinical outcomes after percutaneous coronary intervention (PCI) with sirolimus-eluting stent (SES) compared with non-HD patients and their long-term prognosis remains unclear.
  
  
  RESULTS
  We prospectively enrolled 489 consecutive patients undergoing PCI with SES and performed a retrospective analysis focusing on HD patients. Median follow-up was 7.0 years (interquartile range, 4.2-7.9) and the follow-up rate was 100%. At the 7-year follow-up, the cumulative incidences of all-cause death, target lesion revascularization (TLR) and major adverse cardiac events (MACE) were significantly higher in HD patients than in non-HD patients (HD vs. non-HD=34.7% vs. 9.6%, 42.6% vs. 10.2% and 75.3% vs. 24.4%, respectively; log-rank P<0.001). Cox-proportional hazard analysis revealed that independent predictors of all-cause death were HD (hazard ratio [HR] 2.88, 95% confidence interval [CI]: 1.39-6.00), insulin-treated diabetes mellitus (HR 2.19, 95% CI: 1.17-4.11), heart failure (HR 2.58, 95% CI: 1.25-5.32) and older age (HR 1.06/1-age, 95% CI: 1.02-1.10). Moreover, HD was an independent predictor of TLR (HR 3.63, 95% CI: 1.85-7.11) and MACE (HR 3.54, 95% CI: 2.19-5.73).
  
  
  CONCLUSIONS
  In the present study, Japanese HD patients undergoing PCI with SES showed poorer long-term clinical outcomes than non-HD patients. HD was a strong predictor of long-term adverse events after SES implantation.
authors: Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University.
authors: Nozima
authors: N
authors: Buronova
authors: Kazuho
authors: K
authors: Kamishima
authors: Junichi
authors: J
authors: Yamaguchi
authors: Kentaro
authors: K
authors: Jujo
authors: Erisa
authors: E
authors: Watanabe
authors: Yusuke
authors: Y
authors: Inagaki
authors: Shohei
authors: S
authors: Kishi
authors: Akira
authors: A
authors: Wada
authors: Shinya
authors: S
authors: Hatakeyama
authors: Masahiro
authors: M
authors: Watanabe
authors: Masashi
authors: M
authors: Nakao
authors: Dai
authors: D
authors: Okayama
authors: Hiroyuki
authors: H
authors: Arashi
authors: Norihiro
authors: N
authors: Yamada
authors: Atsushi
authors: A
authors: Takagi
authors: Hiroshi
authors: H
authors: Ogawa
authors: Nobuhisa
authors: N
authors: Hagiwara
mesh_terms: D000367:Age Factors; D000368:Aged; D044466:Asian People; D003324:Coronary Artery Disease / Q000401:mortality / Q000628:therapy; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D006435:Renal Dialysis; D012189:Retrospective Studies; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects; D015996:Survival Rate
chemical_list: D020123:Sirolimus