[Security analysis of implanting drug-eluting stents for unprotected left main coronary artery disease patients with chronic kidney disease].
OBJECTIVE
To study the clinical characteristics and prognosis of unprotected left main (ULM) coronary artery disease patients with chronic kidney disease after drug-eluting stents (DES) implantation.


METHODS
267 ULM coronary artery disease patients who has implanted DES were included in the study from January 2005 to March 2010. Patients were divided into two groups according to their estimated glomerular filtration rate (eGFR): eGFR <60 ml·min(-1)·1.73 m(-2) (77 patients), and eGFR≥ 60 ml·min(-1)·1.73 m(-2) (190 patients) . The clinical parameters and prognosis of ULM patients treated with DES in different eGFR groups were retrospectively compared.


RESULTS
In higher eGFR group, left ventricular ejection fraction (LVEF) and morbidity of coronary ostial lesions were higher than the other group. Cerebrovascular diseases (13.0% vs 5.3%), chronic total occlusion (CTO, 28.6% vs 12.1%), hypertension (70.1% vs 53.2%) were more common in lower eGFR patients(all P<0.05). Total mortality and cardiac mortality were higher in eGFR<60 ml·min(-1)·1.73 m(-2) group (P=0.016, 0.006, respectively). Low eGFR level was an independent risk factor after adjusting multiple factors.


CONCLUSIONS
For the ULM disease patients with reduction in kidney function (eGFR<60 ml·min(-1)·1.73 m(-2)), DES should be selected with a careful study considering its increasing risk of death. Chronic renal insufficiency is a risk factor and may predict poor prognosis for patients with ULM after DES implantation.
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Y
Y
Pan
F
F
Chen
Q
Q
Qiu
X L
XL
Li
X P
XP
Yu
Y W
YW
Luo
Q
Q
Li
H B
HB
Jia
D003324:Coronary Artery Disease; D054855:Drug-Eluting Stents; D006801:Humans; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left