Document Detail

Impact of Chronic Kidney Disease on Long-term Clinical Outcomes After Percutaneous Coronary Intervention With Drug-eluting or Bare-metal Stents.
MedLine Citation:
PMID:  22825536     Owner:  NLM     Status:  In-Data-Review    
Chronic kidney disease (CKD) is associated with adverse outcomes after coronary bare-metal stent (BMS) and drug-eluting stent (DES) implantation, but it is unclear which stent type is associated with lower risk for morbidity and mortality in this population. Uniform treatment standards during coronary stent implantation and a median follow-up period of 2.8 years characterize the FReIburg STent (FRIST) registry, designed as a long-term outcome evaluation of a single tertiary referral cardiovascular center. CKD, defined as creatinine clearance <60 mL/min, was present at baseline in 180 (12%) of 1502 consecutive patients undergoing coronary stent intervention. Patients received first-generation DES (n = 117) or BMS (n = 63). Kaplan-Meier and multivariate Cox model analyses were applied to compare survival rates and adjust for existing clinical, procedural, and angiographic differences between the patients. The primary end point was mortality (cardiac and noncardiac death) and secondary end points were recurrent myocardial infarction, stent thrombosis, target vessel revascularization, sepsis, and major bleeding. Patients with a glomerular filtration rate <60 mL/min had a higher mortality rate (28.3% vs. 10.1%, P < 0.001) than patients with a good renal function. In patients with CKD, there was no difference in mortality rates in the BMS vs. the DES group (hazard ratio, 0.971; 95% confidence interval, 0.48-1.954). In summary, patients with CKD have significantly higher rates of death, but there appears to be no difference in long-term clinical outcomes of first-generation DES compared with BMS implantation during primary percutaneous coronary intervention.
Sophia Kersting; Thorsten Grumann; Johanna Hummel; Dieter Hauschke; Christoph Bode; Christoph Hehrlein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  11     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-07-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  152-9     Citation Subset:  IM    
From the *Department of Cardiology and †Department of Medical Statistics, University of Freiburg, Freiburg, Germany.
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