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Impact of chronic kidney disease on a re-percutaneous coronary intervention for sirolimus-eluting stent restenosis.
MedLine Citation:
PMID:  22975841     Owner:  NLM     Status:  Publisher    
OBJECTIVES: Recurrent in-stent restenosis remains an important clinical issue after a percutaneous coronary intervention even after treatment with a sirolimus-eluting stent (SES) especially in patients with chronic kidney disease. We evaluated the impact of renal insufficiency on the clinical and angiographic outcomes after treatment for SES restenosis. METHODS AND RESULTS: A total of 74 patients with 76 lesions underwent subsequent revascularization with a drug-eluting stent for SES restenosis. Patients were classified into three groups: group 1 included 29 patients with an estimated glomerular filtration rate more than 60 ml/min/1.73 m; group 2 included 27 patients with lower estimated glomerular filtration rate (<60 ml/min/1.73 m) without hemodialysis (HD) dependence; and group 3 included 18 patients on HD. Clinical and angiographic follow-up was carried out at 8 months. Late lumen loss at the 8-month follow-up angiography showed progressive increases from group 1 to 2 to 3 (group 1: 0.36±0.39 mm, group 2: 1.11±0.61 mm, group 3: 1.30±0.85 mm, P<0.001). Similarly, compared with group 1, groups 2 and 3 had significantly higher rates of major adverse cardiac events (6.9, 37.0, and 38.9%, respectively, P=0.001), primarily because of a high frequency of target lesion revascularization (8.0, 34.8, and 33.3%, respectively, P=0.019). CONCLUSION: Non-HD-dependent chronic kidney disease patients had increased neointimal growth in the follow-up phase after percutaneous coronary intervention, with a drug-eluting stent for SES restenosis almost equivalent to patients on HD, resulting in higher rates of recurrent restenosis than patients with preserved renal function.
Yutaka Aoyama; Haruo Hirayama; Hideki Ishii; Koichi Kobayashi; Kiyotake Ishikawa; Masateru Takigawa; Mamoru Nanasato; Yukihiko Yoshida; Toru Aoyama; Daiji Yoshikawa; Tatsuaki Matsubara; Toyoaki Murohara
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-11
Journal Detail:
Title:  Coronary artery disease     Volume:  -     ISSN:  1473-5830     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
aDepartment of Cardiology, Nagoya University Graduate School of Medicine bDepartment of Cardiology, Nagoya Daini Red Cross Hospital cDepartment of Cardiology, Nagoya Kyoritsu Hospital dDepartment of Internal Medicine, School of Dentistry, Aichi-Gakuin University, Nagoya, Japan.
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