title: Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study.
abstract: OBJECTIVE
  To investigate the efficacy and long-term clinical benefits of DES for dialysis patients.
  
  
  BACKGROUND
  It is unclear whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation is associated with lower rates of major adverse cardiovascular events (MACE) or mortality compared to bare-metal stents (BMS).
  
  
  METHODS
  From a nationwide cohort selected from Taiwan's National Health Insurance Research Database, we enrolled 2,835 dialysis patients who were hospitalized for PCI treatment with stent implantation from Dec 1, 2006. Follow-up was from the date of index hospitalization for PCI until the first MACE, date of death, or December 31, 2011, whichever came first.
  
  
  RESULTS
  A total of 738 patients (26.0%) had DES implanted, and 2,097 (74%) had BMS implanted. The medium time to the first MACE was 0.53 years (interquartile range: 0.89 years; range: 0-4.62 years). At 1-year follow-up, patients treated with BMS had significantly, non-fatal myocardial infarction (MI), all-cause mortality, and composite MACE compared to those treated with DES. The overall repeat revascularization with coronary artery bypass graft (CABG), non-fatal MI, all-cause mortality, and composite MACE were significantly lower in patients treated with DES than those treated with BMS. Multivariate cox regression analysis showed that older age, history of diabetes, history of heart failure, history of stroke, and DES vs. BMS were independent significant predictors of MACE.
  
  
  CONCLUSIONS
  DES implantation conferred survival benefits in dialysis patients compared with BMS implantation.
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Hsin-Fu
authors.initials: HF
authors.lastname: Lee
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Lung-Sheng
authors.initials: LS
authors.lastname: Wu
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Yi-Hsin
authors.initials: YH
authors.lastname: Chan
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Cheng-Hung
authors.initials: CH
authors.lastname: Lee
authors.affiliation: Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Jia-Rou
authors.initials: JR
authors.lastname: Liu
authors.affiliation: Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Hui-Tzu
authors.initials: HT
authors.lastname: Tu
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Ming-Shien
authors.initials: MS
authors.lastname: Wen
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Chi-Tai
authors.initials: CT
authors.lastname: Kuo
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Wei-Jan
authors.initials: WJ
authors.lastname: Chen
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Yung-Hsin
authors.initials: YH
authors.lastname: Yeh
authors.affiliation: Department of Public Health, College of Medicine, Chang Gung University, Taoyuan, Taiwan.|Biostatistics Core Laboratory, Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Lai-Chu
authors.initials: LC
authors.lastname: See
authors.affiliation: Chang Gung University and Department of Cardiology, Chang Gung Memorial Hospital, Taipei, Taiwan.
authors.forename: Shang-Hung
authors.initials: SH
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D006435:Renal Dialysis; D013624:Taiwan; D016896:Treatment Outcome