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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Clinical outcomes after percutaneous coronary intervention with drug-eluting stents in dialysis patients

Salah-Eddine Hassani1, William W Chu, Roswitha M Wolfram

  • 1Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC, USA.

The Journal of Invasive Cardiology
|June 6, 2006
PubMed

Insights

Percutaneous coronary interventions with drug-eluting stents (DES) are safe for dialysis patients, showing similar repeat revascularization rates. However, dialysis patients experienced higher mortality within six months due to comorbidities.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Revascularization in dialysis patients undergoing percutaneous coronary interventions (PCI) with drug-eluting stents (DES) is controversial.
  • Dialysis patients are often excluded from major clinical trials, limiting evidence-based treatment guidelines.

Purpose of the Study:

  • To compare clinical outcomes of dialysis versus nondialysis patients after coronary DES implantation.
  • To assess the safety and feasibility of PCI with DES in patients with end-stage renal disease.

Main Methods:

  • A retrospective analysis of 3,442 patients undergoing PCI with DES implantation.
  • Comparison of periprocedural, 1-month, and 6-month clinical outcomes between dialysis (n=72) and nondialysis (n=3,370) groups.

Main Results:

  • Dialysis patients had higher prevalence of comorbidities including hypertension, diabetes, and lower ejection fraction.
  • Procedural success was higher in nondialysis patients, with a trend towards lower in-hospital mortality.
  • At 6 months, restenosis rates were similar, but mortality was significantly higher in dialysis patients (16% vs. 3.8%).

Conclusions:

  • PCI with DES is safe and feasible in dialysis patients, achieving similar reductions in repeat revascularization.
  • Higher 6-month mortality in dialysis patients is attributed to comorbidities and severe presentation.
  • Cardiogenic shock identified as an independent predictor of mortality in this population.
Abstract

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