Influence of hemodialysis duration on mid-term clinical outcomes in hemodialysis patients with coronary artery disease after drug-eluting stent implantation

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• 作者：Norihiro Kobayashi ; Toshiya Muramatsu ; Reiko Tsukahara ; Yoshiaki Ito…
• 关键词：Renal dialysis ; Coronary artery disease ; Percutaneous coronary intervention ; Drug ; eluting stents
• 刊名：Heart and Vessels
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：31
• 期：3
• 页码：330-340
• 全文大小：727 KB
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• 作者单位：Norihiro Kobayashi (1)
  Toshiya Muramatsu (1)
  Reiko Tsukahara (1)
  Yoshiaki Ito (1)
  Hiroshi Ishimori (1)
  Keisuke Hirano (1)
  Masatsugu Nakano (1)
  Masahiro Yamawaki (1)
  Motoharu Araki (1)
  Hideyuki Takimura (1)
  Yasunari Sakamoto (1)
  
  1. Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

Accelerated atherosclerosis in prolonged maintenance hemodialysis (HD) has been recognized; however, whether HD duration is associated with poor clinical outcome in HD patients with coronary artery disease (CAD) after drug-eluting stent (DES) implantation is unknown. We evaluated the impact of HD duration on clinical outcomes in HD patients with CAD after DES implantation. Between April 2007 and December 2012, 168 angina pectoris patients (320 de novo lesions) on HD were treated with DES. Major adverse cardiovascular events (MACE) and target lesion revascularization (TLR) were investigated at 3 years according to the HD duration (≤3 years, 83 patients; >3 years, 85 patients). The incidence of MACE was significantly higher in the long HD duration group (25.3 vs. 50.6 %; P = 0.001). Especially, sudden cardiac death (SCD) was significantly higher in the long HD duration group (3.6 vs. 16.5 %; P = 0.006). On the other hand, the rates of TLR were similar between the two groups (12.0 vs. 14.1 %; P = 0.69). Cox’s proportional hazard analysis revealed that HD duration (HR 1.08 per year, 95 % CI 1.03–1.13, P = 0.002), β-blocker use (0.28, 0.17–0.46, P < 0.001), and diabetes mellitus (2.10, 1.23–3.56, P = 0.007) were independent predictors of MACE. Longer HD duration did not affect TLR; however, SCD was significantly higher in the long HD duration group.