ヤマグチ ジユンイチ   YAMAGUCHI JUNICHI
  山口 淳一
   所属   医学部 医学科(東京女子医科大学病院)
   職種   特任教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Long-term clinical outcomes after percutaneous coronary intervention to treat long lesions in hemodialysis patients in the era of second-generation drug-eluting stents.
掲載誌名 正式名:Journal of cardiology
略  称:J Cardiol
ISSNコード:18764738/09145087
掲載区分国外
出版社 Elsevier B.V.
巻・号・頁 in press頁
著者・共著者 SOONTORNDHADA Kanintorn†, TANAKA Kazuki†, YAMAGUCHI Junichi*, KONAMI Yutaka, OOTSUKI Hisao, NAKAO Masashi, JUJO Kentaro, ARASHI Hiroyuki, HAGIWARA Nobuhisa
発行年月 2019/10
概要 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.
DOI 10.1016/j.jjcc.2019.09.004
PMID 31615745