Impact of intravascular ultrasound-guided minimum-contrast coronary intervention on 1-year clinical outcomes in patients with stage 4 or 5 advanced chronic ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-10-20

AUTHORS

Katsuaki Sakai, Yuji Ikari, Mamoru Nanasato, Hiroshi Umetsu, Masaaki Okutsu, Tomonobu Takikawa, Satoru Sumitsuji, Kenji Sadamatsu, Masanori Takada, Yasuko Kato, Nobuyuki Ogasawara, Kanichi Otowa

ABSTRACT

This study aims to elucidate 1-year clinical outcomes using this technique for patients with stage 4 or 5 advanced chronic kidney disease (CKD). Research has proven that imaging-guided percutaneous coronary intervention (PCI) reduces contrast volume significantly; however, only short-term clinical benefits have been reported. Minimum-contrast (MINICON) studies are based on the registry design pattern to enroll PCI results in patients with advanced CKD stage 4 or 5 comorbid with coronary artery disease. We excluded cases of emergency PCI or maintenance dialysis from this study. In this study, we compared the intravascular ultrasound (IVUS)-guided MINICON PCI group (n = 98) with the angiography-guided standard PCI group (n = 86). Enrollment of the MINICON studies started in 2006. Before 2012, IVUS-guided MINICON PCI was performed only in 14% (stage 1), but it was 100% after 2012 (stage 2). The enrollment finished in 2016. The IVUS-guided MINICON PCI group exhibited a significantly reduced contrast volume (22 ± 20 vs. 130 ± 105 mL; P < 0.0001) and contrast-induced acute kidney injury (CI-AKI; 2% vs. 15%; P = 0.001). The PCI success rate was similarly high (100% vs. 99%; P = 0.35). At 1 year (follow-up rate, 100%), we observed less induction of renal replacement therapy (RRT; 2.7% vs. 13.6%; P = 0.01), but all-cause mortality or myocardial infarction was similar in both groups. The IVUS-guided MINICON PCI reduces CI-AKI significantly and induction of RRT at 1 year in patients with stage 4 or 5 advanced CKD. More... »

PAGES

234-241

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12928-018-0552-7

DOI

http://dx.doi.org/10.1007/s12928-018-0552-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1107739502

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30343351


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