Clinical and angiographic outcomes of paclitaxel-eluting coronary stent implantation in hemodialysis patients: A prospective multicenter registry: The OUCH-TL study (outcome in hemodialysis of TAXUS Liberte)

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• 作者：Ken Kozuma ; MD ; PhD ; FJCC^a ; ^{PXE00364@nifty.com" class="auth_mail" title="E-mail the corresponding author} ; Masaya Otsuka ; MD^b ; Yuji Ikari ; MD ; PhD ; FJCC^c ; Yoshiki Uehara ; MD^d ; Hiroyoshi Yokoi ; MD^e ; Koichi Sano ; MD^f ; Kengo Tanabe ; MD ; PhD^g ; Kiyoshi Hibi ; MD ; FJCC^h ; Masahisa Yamane ; MDⁱ ; Sugao Ishiwata ; MD ; FJCC^j ; Hiroshi Ohta ; MD^k ; Yasutaka Yamauchi ; MD^l ; Nobuhiro Suematsu ; MD^m ; Mio Nakayama ; MDⁿ ; Naoto Inoue ; MD ; FJCC^o ; Hiroyuki Kyono ; MD^a ; Nobuaki Suzuki ; MD^a ; Takaaki Isshiki ; MD ; FJCC^a
• 关键词：Kidney ; Coronary heart disease ; Prognosis ; Hemodialysis ; Drug-eluting stent
• 刊名：Journal of Cardiology
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：66
• 期：6
• 页码：502-508
• 全文大小：771 K

文摘

The outcome of percutaneous coronary intervention (PCI) has been reported to be poor in hemodialysis (HD) patients even in the drug-eluting stent era. We have reported relatively poor outcomes after sirolimus-eluting stent implantation in the OUCH study.

Methods

The OUCH-TL study is a prospective, non-randomized, single-arm registry designed to assess the results of paclitaxel-eluting stent (PES) in HD patients with follow-up quantitative coronary angiography analysis. The primary endpoint was the occurrence of target-vessel failure (TVF) defined as cardiac death, myocardial infarction (MI), and target-vessel revascularization (TVR) at 12 months.

Results

A total of 119 patients with 154 lesions were enrolled (one withdrawal). Mean age was 65 ± 10 years, male gender was 79%, 89% of cases had stable coronary disease. Diabetic nephropathy was diagnosed in 61% of the patients. American College of Cardiology/American Heart Association type B2/C accounted for 96% of lesions and 22.7% of lesions were treated with Rotablator (Boston Scientific Corporation, Natick, MA, USA). Rates of TVF, death, MI, stent thrombosis and TVR at 12 months were 20.2%, 5.9%, 5.0%, 1.4%, and 12.6%, respectively. TVR was performed in 8.4% of the patients up to 12 months. Late loss in-stent was 0.48 ± 0.61 mm, and late loss in-segment was 0.37 ± 0.61 mm at 9 months. Binary restenosis in-stent was 10.3% and in-segment was 14.5%.

Conclusions

Outcomes of PES implantation in hemodialysis patients appears comparable to those of non-hemodialysis patients.