Sirolimus-eluting stents vs bare metal stents for coronary intervention in Japanese patients with renal failure on hemodialysis
Sirolimus-eluting stents vs bare metal stents for coronary intervention in Japanese patients with renal failure on hemodialysis
复制标题
DOI：
10.1253/circj.72.56
复制
发表时间：
2008-01-01
影响因子：
3.3
通讯作者：
Murohara, Toyoaki
中科院分区：
文献类型：
--
作者：
Aoyama, Toru;Ishii, Hideki;Murohara, Toyoaki
背景：动脉粥样硬化加速是接受血液透析（HD）的长期幸存者的主要风险，冠状动脉事件是死亡的主要原因。方法与结果将88例连续行经皮冠状动脉介入治疗（PCI）合并西罗莫司洗脱支架（SES）的HD患者（121个病变）与78例前1年接受裸金属支架（BMS）的HD患者（95个病变）进行比较。主要终点是PCI术后6-8个月的血管造影再狭窄，定义为>= 50%直径狭窄。随访时血管造影再狭窄率SES组为22.2%，BMS组为24.4%。两组患者再狭窄率差异无统计学意义（p=0.73）。当纳入HD和非HD患者时，SES植入后再狭窄的独立预测因素是HD治疗(风险比（HR） 3.12；95%置信区间（CI） 1.23 ~ 7.95；p=0.016)、高脂血症发生率（HR 3.93; 95%CI 1.12-13.7; p=0.032）、冠状动脉钙化（HR 2.78; 95%CI 1.12-6.91; p=0.027）、多支架植入术（FIR 4.14; 95%CI 1.70-10.1; p=0.0017）。结论即使采用SES治疗，终末期肾衰竭患者PCI术后再狭窄的风险仍然很高。
Background Accelerated atherosclerosis is a major risk for long-term survivors receiving hemodialysis (HD), with coronary events being the leading cause of mortality.Methods and Results A total of 88 consecutive patients on HD (121 lesions) who underwent percutaneous coronary intervention (PCI) with sirolimus-eluting stents (SES) were compared with 78 patients on HD (95 lesions) who received bare metal stents (BMS) in the preceding 1 year. The primary endpoint was angiographic restenosis defined as >= 50% diameter stenosis at 6-8 months follow-up after PCI. The angiographic restenosis rate at follow-up was 22.2% in the SES group and 24.4% in the BMS group. No difference was detected in the restenosis rate between the 2 groups (p=0.73). When including both HD and non-HD patients, the independent predictors for restenosis after SES implantation were treatment with HD (hazard ratio (HR) 3.12; 95%confidence interval (CI) 1.23-7.95; p=0.016), incidence of hyperlipidemia (HR 3.93; 95%CI 1.12-13.7; p=0.032), coronary calcification (HR 2.78; 95%CI 1.12-6.91; p=0.027), and implantation of multi-stents (FIR 4.14; 95%CI 1.70-10.1; p=0.0017).Conclusions Even if treated with SES, patients with end-stage renal failure on HD are at high risk of restenosis after PCI.