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


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2014-12-19

AUTHORS

Norihiro Kobayashi, Toshiya Muramatsu, Reiko Tsukahara, Yoshiaki Ito, Hiroshi Ishimori, Keisuke Hirano, Masatsugu Nakano, Masahiro Yamawaki, Motoharu Araki, Hideyuki Takimura, Yasunari Sakamoto

ABSTRACT

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. More... »

PAGES

330-340

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00380-014-0615-3

DOI

http://dx.doi.org/10.1007/s00380-014-0615-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1019045217

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25523891


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32 schema:description 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.
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40 DES
41 DES implantation
42 HD duration
43 HD patients
44 TLR
45 accelerated atherosclerosis
46 adverse cardiovascular events
47 analysis
48 angina pectoris patients
49 artery disease
50 atherosclerosis
51 cardiac death
52 cardiovascular events
53 clinical outcomes
54 coronary artery disease
55 death
56 disease
57 drug-eluting stent implantation
58 duration
59 duration group
60 events
61 group
62 hand
63 hazard analysis
64 hemodialysis
65 hemodialysis duration
66 hemodialysis patients
67 impact
68 implantation
69 incidence
70 incidence of MACE
71 independent predictors
72 influence
73 lesion revascularization
74 longer HD duration
75 maintenance hemodialysis
76 major adverse cardiovascular events
77 mellitus
78 mid-term clinical outcomes
79 outcomes
80 patients
81 poor clinical outcome
82 predictors
83 prolonged maintenance hemodialysis
84 proportional hazards analysis
85 rate
86 rate of TLR
87 revascularization
88 stent implantation
89 sudden cardiac death
90 use
91 years
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