Document Detail


Impact of chronic kidney disease on the efficacy of drug-eluting stents: long-term follow-up study.
MedLine Citation:
PMID:  21503391     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Patients with chronic kidney disease (CKD) submitted to coronary angioplasty have higher rates of target lesion revascularization (TLR) and mortality. Drug-eluting stents (DES) are associated with a lower rate of restenosis, compared to bare metal stents (BMS), although data on DES efficacy and safety is limited in patients with CKD.
OBJECTIVE: We sought to evaluate the safety and efficacy of DES in patients with significant CKD as compared to patients without normal renal function in a real world registry.
METHODS: 504 patients who underwent percutaneous coronary intervention with DES in two centers were included. Outcomes were stratified based on the presence of CKD, defined as a baseline glomerular filtration rate (GFR) < 60 ml/min/1.73 m².
RESULTS: The mean follow-up was 22.7 months. CKD was present in 165 patients (32.7%). Patients with CKD were older, had a higher incidence of hypertension and diabetes. CKD patients presented an increased incidence of death (12.3% vs 2.4%, p < 0.001) and myocardial infarction (MI) (7.4% vs 3.3%, p = 0.04) compared to patients without CKD. TLR rates were similar between groups (4.8% vs 5.6%, p = 0.7, CKD and no CKD patients, respectively). Independent predictors of death were CKD (HR 6.93; 2.4 - 19.5, p < 0.001), current smoking (HR 3.66; 1.20 - 11.10, p = 0.02) and diabetes (HR 2.66; 1.03 - 6.60, p = 0.045).
CONCLUSION: In this registry, coronary intervention with DES in patients with CKD was associated with similar TLR compared to patients without CKD, demonstrating the efficacy of DES in preventing in-stent restenosis in this patient population. CKD was related to significantly increased MI and mortality rates.
Authors:
Vitor Osório Gomes; Patrícia Blaya; Ricardo Lasevitch; Denise Oliveira; Patrícia Hickmann; Luís Smidt; Carisi Polanczyk; Paulo Caramori
Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2011-04-15
Journal Detail:
Title:  Arquivos brasileiros de cardiologia     Volume:  96     ISSN:  1678-4170     ISO Abbreviation:  Arq. Bras. Cardiol.     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-05-23     Completed Date:  2011-12-07     Revised Date:  2012-03-15    
Medline Journal Info:
Nlm Unique ID:  0421031     Medline TA:  Arq Bras Cardiol     Country:  Brazil    
Other Details:
Languages:  eng; por; spa     Pagination:  346-51     Citation Subset:  IM    
Affiliation:
Hospital São Lucas da Pontifícia Universidade, Católica do Rio Grande do Sul, Brasil. vigomes@cardiol.br
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiovascular Diseases / mortality*
Case-Control Studies
Chi-Square Distribution
Drug-Eluting Stents / adverse effects*
Female
Follow-Up Studies
Glomerular Filtration Rate / physiology
Humans
Male
Middle Aged
Reference Values
Renal Insufficiency, Chronic / physiopathology*
Risk Factors
Comments/Corrections
Comment In:
Arq Bras Cardiol. 2012 Jan;98(1):95, author reply 95   [PMID:  22323325 ]
Erratum In:
Arq Bras Cardiol. 2011 Jun;96(6):519

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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