Department School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine Position Assistant Professor
|Article types||Original article|
|Peer review||Peer reviewed|
|Title||Long-term clinical outcomes after percutaneous coronary intervention to treat long lesions in hemodialysis patients in the era of second-generation drug-eluting stents.|
|Journal||Formal name：Journal of cardiology|
|Domestic / Foregin||Foregin|
|Volume, Issue, Page||in press頁|
|Author and coauthor||SOONTORNDHADA Kanintorn†, TANAKA Kazuki†, YAMAGUCHI Junichi*, KONAMI Yutaka, OOTSUKI Hisao, NAKAO Masashi, JUJO Kentaro, ARASHI Hiroyuki, HAGIWARA Nobuhisa|
|Summary||BACKGROUND:There is little knowledge about clinical outcomes after the percutaneous coronary intervention (PCI) in hemodialysis patients with long lesions. The objective of the present study was to examine the long-term prognosis after PCI in hemodialysis patients in the second-generation drug-eluting stents (DES) era.
METHODS:We retrospectively enrolled 270 consecutive hemodialysis patients who underwent PCI using second-generation DES from January 2010 to July 2015. We defined long lesions as the total stent length >30mm. In total, 96 hemodialysis patients (35.6%) underwent PCI for long lesions. The median follow-up period was 2.7 years. The endpoints of this study were cardiac death, target lesion revascularization (TLR), and major adverse cardiovascular events (MACE), including cardiac death, non-fatal myocardial infarction, non-fatal stroke, stent thrombosis, and TLR.
RESULTS:The patients' baseline characteristics were similar between the long lesion and the non-long lesion groups, except for prior PCIs (long-lesion vs. non-long lesion=30.2% vs. 46.0%; p= 0.01). Kaplan-Meier analyses revealed that the incidence of cardiac death, TLR, and MACE were comparable between the two groups (long lesion vs. non-long lesion; 5.2% vs. 5.7%, log-rank p=0.84, 26.0% vs. 23.0%, log-rank p=0.29, and 43.8% vs. 40.2%; log-rank p=0.49, respectively).
CONCLUSIONS:Clinical outcomes of PCI for long lesions in hemodialysis patients were similar to that of non-long lesions. Long-stenting in hemodialysis patients, who were considered high-risk subset of adverse cardiovascular events, might be acceptable in the second-generation DES era.