[Limitation on efficacy of sirolimus-eluting stent implantation in patients on hemodialysis].

Abstract:

BACKGROUND:Patients receiving chronic hemodialysis develop complicated coronary lesions with tortuosity and calcification, which make stent delivery or expansion difficult. Restenosis rates are also higher than in patients without hemodialysis. Furthermore, there is a risk of polymer rubbing from the surface of a sirolimus-eluting stent(SES)placed across a calcified lesion. This study investigated the efficacy of SES for patients on hemodialysis compared with bare metal stent (BMS). METHODS AND RESULTS:Forty-two patients on hemodialysis underwent percutaneous coronary intervention for 46 de novo lesions treated with SES (SES group). Seventy-four patients with 78 de novo lesions were treated with BMS (BMS group). The mean age was 65.8 +/- 9.3 yr in the SES group, and 65.0 +/- 8.7 yr in the BMS group. The mean hemodialysis period was significantly longer in the SES group (9.2 +/- 7.9 vs 6.5 +/- 7.7 yr, p < 0.01). Angiographic characteristics and acute results showed no significant difference between the two groups. At 6 months follow-up, late loss was significantly smaller in the SES group (0.60 +/- 0.97 vs 1.60 +/- 1.15 mm, p < 0.05). Binary restenosis and target lesion revascularization were similar (34% vs 43%, 25% vs 36%, respectively, p = NS). Major adverse cardiac events, composite of death, myocardial infarction, and target vessel revascularization were also similar (23% vs 36%, p = NS). CONCLUSIONS:Our study could not demonstrate the superiority of SES implantation in patients with hemodialysis compared to BMS implantation, which suggests the limitations of using SES.

journal_name

J Cardiol

journal_title

Journal of cardiology

authors

Suzuki K,Inoue N,Matsuo A,Shiono Y,Nakanishi N,Otsuki Y,Nishibori Y,Inoue K,Tanaka T,Fujita H,Kitamura M,Nishimura M

subject

Has Abstract

pub_date

2007-06-01 00:00:00

pages

331-6

issue

6

eissn

0914-5087

issn

1876-4738

journal_volume

49

pub_type

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