Abstract 14723: Sirolimus Eluting Stent is Superior to Paclitaxel Eluting Stent in patients with Chronic Renal Insufficiency.
Introduction: Patients with chronic renal insufficiency (CRI) have been reported having high incidence of mortality, stent thrombosis and restenosis after percutaneous coronary intervention (PCI). The purpose of this study was to find out better coronary stents for patients with CRI.
Hypothesis: We assessed the hypothesis that Sirolimus eluting stent(SES) might be superior to Paclitaxel eluting stent(PES) in CRI.
Methods: Among consecutive 9292 patients performed PCI in COACT (CathOlic medical center percutAneous Coronary inTervention) registry from January 2004 to December 2009, we analyzed 1281 patients with CRI. CRI was defined as estimated Glomerular filtration rate below 60ml/min by Modification of Diet in Renal Disease methods. Primary end point was a composite of major adverse cardiovascular event including death, myocardial infarction, and target vessel revasculariztion .
Results : Patients underwent PCI with sirolimus eluting stent were 611 (67.8%) and paclitaxel eluting stent were 290 (32.2%). And Median follow up period was 801 days (range, 365-1346 days). There were no differences in baseline characteristics except men proportion, previous myocardial infarction, previous PCI, acute coronary syndrome, which factors were more in paclitaxel eluting stent group. Sirolimus eluting stent group had higher low density lipoprotein cholesterol and lower left ventricular ejection fraction. The low efficacy of paclitaxel eluting stent was pronounced in terms of major adverse cardiovascular event (adjusted hazard ratio 1.94, 95% confidence interval 1.364-2.80, p<0.001) by cox hazard regression analysis.
Conclusion: In conclusion, Sirolimus eluting stent was superior to Paclitaxel eluting stent with respect to MACE in patients with CRI.
- © 2011 by American Heart Association, Inc.