Cardiovascular Outcomes in Patients on Hemodialysis following Drug-Eluting versus Bare-Metal Coronary Stents. (17th May 2018)

• Record Type: Journal Article
• Authors: Mohani, Amir F.; Penumetsa, Srikanth; Daoulah, Amin; Giugliano, Gregory; Lotfi, Amir
• Other Names: Chen Robert Academic Editor.
• Is Part Of: Cardiology research and practice. Volume 2018(2018)
• Publication Date: 2018-05-17
• Subjects: Cardiology -- Research -- Periodicals; Cardiology -- Periodicals; Cardiology; Cardiology; Cardiology -- Research; Electronic journals; Periodicals; Periodicals; 616.12
• DOI: 10.1155/2018/4934982
• Languages: English
• ISSNs: 2090-8016

Abstract

Abstract : Aim . This study sought to compare short- and long-term outcomes of drug-eluting stents (DESs) versus bare-metal stents (BMSs) implantation in patients with end-stage renal disease on hemodialysis (ESRD-HD) undergoing percutaneous coronary intervention (PCI). Methods . Adult patients with ESRD-HD who underwent PCI at all nonfederal hospitals in Massachusetts between July 1, 2003, and September 30, 2007, were stratified based on the stent type placed at index hospitalization: DES or BMS. The primary outcome compared was a composite of all-cause death, myocardial infarction (MI), congestive heart failure (CHF), target vessel revascularization (TVR), and stroke at 30 days and one year. Results . HD patients had a high mortality (31%) and were more likely to receive a DES than a BMS (77% versus 23%). Propensity score analysis of 2 : 1 matched DES (268) versus BMS (134) patients demonstrated the DES group to more likely have proximal LAD disease and a history of prior PCI. Conditional logistic regression analysis demonstrated no significant difference in the composite cardiovascular endpoint measured at 30 days (hazard ratio (HR) 1.09; 95% confidence interval (CI) 0.61–1.94) and one year (HR 1.03; 95% CI 0.68–1.57). Conclusions . There were no significant differences in 30-day or 1-year major cardiovascular outcomes in HD patients undergoing PCI using the DES compared to the BMS in this high-mortality patient cohort.