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10.1016/j.jacc.2015.10.104

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suck abstract from ncbi


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pmid27012407      J+Am+Coll+Cardiol 2016 ; 67 (12): 1459-69
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  • Drug-Eluting Versus Bare-Metal Stents During PCI in Patients With End-Stage Renal Disease on Dialysis #MMPMID27012407
  • Chang TI; Montez-Rath ME; Tsai TT; Hlatky MA; Winkelmayer WC
  • J Am Coll Cardiol 2016[Mar]; 67 (12): 1459-69 PMID27012407show ga
  • BACKGROUND: In patients undergoing percutaneous coronary intervention (PCI), drug-eluting stents (DES) reduce repeat revascularizations compared with bare metal stents (BMS), but their effects on death and myocardial infarction (MI) are mixed. Few studies have focused on patients with end-stage renal disease (ESRD). OBJECTIVES: We compared mortality and cardiovascular morbidity during PCI with DES and with BMS in dialysis patients. METHODS: We identified 36,117 dialysis patients from the U.S. Renal Data System who had coronary stenting in the U.S. between 4/23/03 and 12/31/10, and examined the association of DES versus BMS with 1-year outcomes: death; death or MI; and death, MI or repeat revascularization. We conducted a temporal analysis by dividing the study period into 3 DES eras: Transitional (4/23/03 ? 6/30/04); Liberal (7/1/04 ? 12/31/06); and Selective (1/1/07 ? 12/31/10). RESULTS: One-year event rates were high, with 38 deaths, 55 death or MI events and 71 death, MI or repeat revascularization events per 100 person-years. DES was associated with a significant 18% lower risk of death, 16% lower risk of death or MI, and 13% lower risk of death, MI or repeat revascularization, compared with BMS. DES use varied, from 56% in the Transitional era to 85% in the Liberal era and 62% in the Selective era. DES outcomes in the Liberal era were significantly better than in the Transitional Era, but not significantly better than in the Selective Era. CONCLUSIONS: DES for PCI appears safe in U.S. dialysis patients, and is associated with lower rates of death, MI and repeat revascularization.



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