Impact of drug-eluting stents on clinical and angiographic outcomes in dialysis patients

Circ J. 2007 Oct;71(10):1525-9. doi: 10.1253/circj.71.1525.

Abstract

Background: It remains unclear whether sirolimus-eluting stents (SES) have an advantage over bare metal stents (BMS) in patients on dialysis.

Methods and results: Percutaneous coronary intervention (PCI) using SES was performed in 54 dialysis patients with 69 lesions. A control group for comparison comprised 54 consecutive dialysis patients with 58 lesions who underwent PCI using BMS. Angiographic and clinical follow-ups were scheduled at 9 months. After the procedure, minimum lumen diameter (MLD) was similar between the 2 groups. At follow-up, the SES group had a higher MLD than the BMS group (1.98+/-0.83 mm vs 1.50+/-0.78 mm, p<0.01). In-stent restenosis rate was lower in lesions treated with SES than in those with BMS (22% vs 40%, p=0.048). However, there was no significant difference between the 2 groups for in-segment restenosis (31% vs 43%, p=0.3). During follow-up, there was no significant difference in the incidence of death, myocardial infarction or target lesion revascularization (TLR) (14% vs 21%, p=0.4) between the SES and BMS groups.

Conclusions: In this retrospective study, SES, in comparison with BMS, reduced in-stent restenosis in patients on dialysis. However, in-segment restenosis and TLR were not statistically different between lesions treated with SES and those with BMS.

Publication types

  • Evaluation Study

MeSH terms

  • Acute Coronary Syndrome / complications
  • Acute Coronary Syndrome / physiopathology
  • Acute Coronary Syndrome / surgery*
  • Aged
  • Angioplasty, Balloon, Coronary / instrumentation
  • Angioplasty, Balloon, Coronary / methods*
  • Case-Control Studies
  • Coronary Angiography
  • Coronary Restenosis
  • Coronary Vessels / physiopathology
  • Drug-Eluting Stents*
  • Female
  • Humans
  • Immunosuppressive Agents / administration & dosage
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy*
  • Male
  • Middle Aged
  • Regional Blood Flow / physiology
  • Renal Dialysis*
  • Retrospective Studies
  • Sirolimus / administration & dosage
  • Stents
  • Treatment Outcome
  • Vasoconstriction / physiology

Substances

  • Immunosuppressive Agents
  • Sirolimus