| Long-term benefits and risks of drug-eluting compared to bare-metal stents in patients with versus without chronic kidney disease. | |
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MedLine Citation:
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PMID: 23453439 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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AIMS: Chronic kidney disease (CKD) is associated with worse outcomes in patients with coronary artery disease (CAD). How CKD influences the benefit-risk balance of drug-eluting stents (DES) versus bare-metal stents (BMS) is less known. METHODS AND RESULTS: In the multicentre BASKET-PROVE trial, 2314 patients in need of large coronary stenting (≥3.0mm) were randomised 2:1 to DES or BMS. In an a priori planned secondary analysis, outcomes were evaluated according to renal function defined by estimated glomerular filtration rates (eGFR; normal: eGFR≥60ml/min/1.73m2; CKD: eGFR<60ml/min/1.73m2). The primary endpoint was the first major adverse cardiac event (MACE: cardiac death, myocardial infarction, target vessel revascularisation) up to 2years. A Cox proportional-hazard model was used to evaluate adjusted relative risks (hazard rates, HRs) for BMS versus DES. The interaction of stent type and renal function was tested. CKD patients (189 (11.2%)/1681 with such data) had a 2-year MACE rate of 8.5% versus 7.4% in those without CKD [HR 0.98 (0.56-1.72), p=0.95] with cardiac mortalities of 5.3% and 1.5%, respectively (p=0.002, non-significant after baseline adjustments). The MACE rate was lower in CKD patients with DES than with BMS [4.9% versus 15.2%, p=0.017, HR 0.29(0.10-0.80)] as was the MACE rate in patients without CKD [5.6% with DES versus 11.1% with BMS, p<0.0001, HR 0.51(0.35-0.75)]. No significant interaction between stent type and renal function was found. CONCLUSIONS: This analysis of patients needing large coronary artery stenting confirms the increased mortality of CKD patients and documents a long-term benefit of DES compared to BMS irrespective of kidney function. |
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Authors:
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Maria Wanitschek; Matthias Pfisterer; Anders Hvelplund; Stefano De Servi; Osmund Bertel; Raban Jeger; Peter Rickenbacher; Allan Iversen; Jan Skov Jensen; Soeren Galatius; Christoph Kaiser; Hannes Alber; |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2013-2-27 |
Journal Detail:
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Title: International journal of cardiology Volume: - ISSN: 1874-1754 ISO Abbreviation: Int. J. Cardiol. Publication Date: 2013 Feb |
Date Detail:
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Created Date: 2013-3-4 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8200291 Medline TA: Int J Cardiol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2013 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Cardiology, Innsbruck Medical University, Austria. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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