Abstract 3663: Drug-Eluting Stents versus Bare Metal Stents for Coronary Intervention in Patients with Renal Failure on Chronic Hemodialysis
Background: Drug-eluting stents (DES) significantly reduce the risk of restenosis after percutaneous coronary intervention (PCI). On the other hand, it is recognized that chronic kidney disease (CKD) requiring maintenance HD is a major risk for accelerated atherosclerosis , because coronary events are the major cause of mortality in patients with CKD. However, there are limited reports examining the effects on cardiovascular events after coronary stenting in patients with end-stage renal disease on maintenance hemodialysis (HD).
Methods: Eighty-eight consecutive patients (121 lesions) on HD who underwent exclusively with sirolimus-eluting stents (DES group) were compared with 78 patients (95 lesions) on HD who received bare metal stents in the preceding 1 year (BMS group). We analyzed quantitative coronary angiography and defined ≥50% diameterstenosis at 6 – 8 months follow-up angiography as restenosis.
Results: Baseline clinical characteristics were similar between the two groups. For all the patients after PCI, there were no angiographically residual stenosis remained and there were no death during initial PCI procedure, either. Angiographic follow-up was obtained in 84 lesions in the DES group and 71 lesions in the BMS group. The rate of binary (>50% diameter stenosis) angiographic restenosis was similar (24.4% in the DES group and 22.2% in the BMS group, p = 0.72). Late lumen loss at follow-up was also comparable between the two groups (0.54±0.84 vs. 0.70±0.84, p = 0.22) (see Table⇓).
Conclusions: Even if treated with DES, patients with end-stage renal failure on chronic hemodialysis (HD) are at high risk of restenosis after PCI.