Abstract 1688: Aortic Valvular Calcification Predicts Restenosis After Implantation of Drug-Eluting Stents in Patinets on Chronic Hemodialysis
Background: Even in the drug-eluting stent (DES) era, the restenosis rate of the follow-up period after percutaneous coronary intervention (PCI) is higher in hemodialysis (HD) patients than in non-HD patients, although the initial success rate of PCI is similarly high in both. Therefore, higher restenosis remains a clinical limitation in HD patients, and a simple clinical method to predict patients likely to have restenosis after stent implantation is attractive. The present study investigated the potential relationship between aortic valve calcification (AVC) and angiographical restenosis at follow-up after DES implantation in patients on maintenance HD.
Methods: We prospectively performed echocardiography before elective PCI with DES implantation in 164 HD patients. Angiographic follow-up was scheduled between 6 and 8 months after PCI. Restenosis at follow-up was defined as a diameter stenosis ≥50% by measuring quantitative coronary angiography.
Results: Of the patients enrolled into the study, 103 patients (62.8%) had AVC. Other baseline clinical characteristics were well matched. The angiographical restenosis rate at follow-up period was 26.2% in patients with AVC and 8.2% in patients without AVC (HR 3.97; 95% CI 1.44–11.0, P = 0.0049). Even after multivariate adjustment including covariates related to atherogenecity, AVC remained an independent predictor for restenosis after implanting DES (HR 4.82; 95% CI 1.43–16.2, P = 0.0049). As to quantitative coronary angiography, late loss was significantly lower in the AVC group than in the non-AVC group (0.66 ± 0.88 mm vs. 0.28 ± 0.69 mm, P = 0.0049). Percent diameter stenosis at follow-up was also reduced in the AVC group compared to the non-AVC group (19.9 ± 21.0 % vs. 31.2 ± 30.1 %, P = 0.012(Table⇓).
Conclusions: AVC provides predictive information regarding DES implantation in patients on maintenance HD.