Abstract 15828: Long-Term Clinical Outcomes Following Percutaneous Coronary Intervention With Drug-Eluting Stent in Hemodialysis Patients
Background: Hemodialysis (HD) patients have been recognized as high-risk population of restenosis after percutaneous coronary intervention (PCI) even in drug-eluting stent DES era. The purpose of this study is to evaluate clinical outcome of HD patients treated with DES.
Methods and Results: We analyzed consecutive 147 HD patients including 34 (23.1%) acute coronary syndrome (ACS) implanted DES from March 2009 to March 2012. Mean follow up period was 668 ± 375 days. The mean age of the study population was 66.3 ± 10.4years, and 112 patients (76.2%) were male. The percentage of diabetes was 65.3% and 45.9% of them were insulin user. The mean duration of dialysis was 8.7±8.3 years. The Kaplan-Meier estimates of target lesion revascularization (TLR), all cause death and major adverse cardiac events (MACE) were shown in figure below. The incidences of TLR, all cause death and MACE at 1 year were 13.6%, 10.2%, and 25.9%, respectively. After multivariate analysis, the predictors of TLR were age (Odds ratio [OR] =0.95, 95% confidence interval [CI]: 0.92-0.99, p =0.02), acute coronary syndrome (OR =3.03, 95% CI: 1.26-7.31, p = 0.01) and insulin user (OR =2.53, 95% CI: 1.12-5.71, p = 0.03). The predictors of all cause death were duration of dialysis (OR =1.06, 95% CI: 1.02-1.10, p < 0.01) and male (OR =0.45 95% CI: 0.21-0.95, p = 0.04). The predictors of MACE was low Ejection fraction (OR =2.01, 95% CI: 1.20-3.53, p = 0.01).
Conclusions: Even in drug-eluting stent era, the long-term outcome of HD patients was unfavorable. Low ejection fraction was the strongest predictor of poor prognosis.
- © 2013 by American Heart Association, Inc.