One-year clinical outcomes of dialysis patients after implantation with sirolimus-eluting coronary stents

Circ J. 2008 Sep;72(9):1430-5. doi: 10.1253/circj.cj-08-0010.

Abstract

Background: The efficacy of sirolimus-eluting stents (SESs) has not been established in dialysis patients.

Methods and results: This study was a non-randomized observational single-center registry in a community hospital: data for 80 consecutive dialysis patients who underwent percutaneous coronary intervention (PCI) with SES were compared with those of a historical group of consecutive 124 dialysis patients treated with bare-metal stents (BMS). After 1 year, the cumulative incidence of major adverse cardiac events (MACE), comprising cardiac death, nonfatal myocardial infarction, stent thrombosis, or target lesion revascularization (TLR), was 25.2% in the SES group and 38.2% in the BMS group (p=0.048). In multivariate analysis, use of SES remained an independent predictor of MACE at 1 year after PCI (risk ratio 0.70, 95% confidence interval 0.52-0.93, p=0.015). Rates of TLR were 21.7% in the SES group and 30.9% in the BMS group and (p=0.15). Subgroup analysis showed that use of SES was effective in patients with small vessels, non-diabetic patients, and patients without highly calcified lesions.

Conclusions: In dialysis patients, the implantation of SES was moderately effective in reducing MACE at 1 year after PCI as compared with BMS. However, the TLR rate at 1 year was relatively higher than previously reported.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Aged
  • Cardiac Catheterization*
  • Drug-Eluting Stents*
  • Female
  • Heart Diseases / mortality
  • Heart Diseases / therapy*
  • Humans
  • Immunosuppressive Agents / pharmacology*
  • Male
  • Middle Aged
  • Renal Dialysis*
  • Sirolimus / pharmacology*
  • Time Factors

Substances

  • Immunosuppressive Agents
  • Sirolimus