Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis

Hideki Ishii, Yoshitake Kumada, Takanobu Toriyama, Toru Aoyama, Hiroshi Takahashi, Tetsuya Amano, Yoshinari Yasuda, Yukio Yuzawa, Syoichi Maruyama, Seiichi Matsuo, Tatsuaki Matsubara, Toyoaki Murohara

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Abstract

Background. Even in the drug-eluting stent (DES) era, the restenosis rate of the follow-up period after percutaneous coronary intervention (PCI) is higher in haemodialysis (HD) patients than in non-HD patients. Therefore, higher restenosis remains a clinical limitation in HD patients, and a simple clinical method to predict patients likely to have restenosis after stent implantation is attractive. The present study investigated the potential relationship between aortic valvular calcification (AVC) and angiographical restenosis at follow-up after DES implantation in patients on maintenance HD.Methods. In the study, 97 patients were enrolled. We prospectively performed echocardiography before elective PCI with DES implantation. Angiographic follow-up was scheduled between 6 and 8 months after PCI. Restenosis at follow-up was defined as a diameter stenosis of ≥50 by measuring quantitative coronary angiography.Results. Of the enrolled patients, 59 patients (60.8) had AVC. Complete angiographical follow-up was obtained in 86 patients (88.7). The angiographical restenosis rate during the follow-up period was 24.7 in patients with AVC and 8.9 in patients without AVC hazard ratio (HR) 3.36; 95 confidence interval (CI) 1.18-9.56, P = 0.023. Even after multivariate adjustment including covariates related to atherogenecity, AVC remained an independent predictor of restenosis after implanting DES (HR 3.83; 95 CI 1.14-12.9, P = 0.029). Late lumen loss suggesting neointimal growth after DES implantation was 0.28 ± 0.70 mm in the non-AVC group and 0.64 ± 0.90 mm in the AVC group (P = 0.013).Conclusions. AVC provides predictive information regarding DES implantation in patients on maintenance HD.

Original languageEnglish
Pages (from-to)1562-1567
Number of pages6
JournalNephrology Dialysis Transplantation
Volume24
Issue number5
DOIs
Publication statusPublished - 01-05-2009

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Drug-Eluting Stents
Renal Dialysis
Percutaneous Coronary Intervention
Maintenance
Confidence Intervals
Coronary Angiography
Stents
Echocardiography
Pathologic Constriction

All Science Journal Classification (ASJC) codes

  • Nephrology
  • Transplantation

Cite this

Ishii, Hideki ; Kumada, Yoshitake ; Toriyama, Takanobu ; Aoyama, Toru ; Takahashi, Hiroshi ; Amano, Tetsuya ; Yasuda, Yoshinari ; Yuzawa, Yukio ; Maruyama, Syoichi ; Matsuo, Seiichi ; Matsubara, Tatsuaki ; Murohara, Toyoaki. / Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis. In: Nephrology Dialysis Transplantation. 2009 ; Vol. 24, No. 5. pp. 1562-1567.
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title = "Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis",
abstract = "Background. Even in the drug-eluting stent (DES) era, the restenosis rate of the follow-up period after percutaneous coronary intervention (PCI) is higher in haemodialysis (HD) patients than in non-HD patients. Therefore, higher restenosis remains a clinical limitation in HD patients, and a simple clinical method to predict patients likely to have restenosis after stent implantation is attractive. The present study investigated the potential relationship between aortic valvular calcification (AVC) and angiographical restenosis at follow-up after DES implantation in patients on maintenance HD.Methods. In the study, 97 patients were enrolled. We prospectively performed echocardiography before elective PCI with DES implantation. Angiographic follow-up was scheduled between 6 and 8 months after PCI. Restenosis at follow-up was defined as a diameter stenosis of ≥50 by measuring quantitative coronary angiography.Results. Of the enrolled patients, 59 patients (60.8) had AVC. Complete angiographical follow-up was obtained in 86 patients (88.7). The angiographical restenosis rate during the follow-up period was 24.7 in patients with AVC and 8.9 in patients without AVC hazard ratio (HR) 3.36; 95 confidence interval (CI) 1.18-9.56, P = 0.023. Even after multivariate adjustment including covariates related to atherogenecity, AVC remained an independent predictor of restenosis after implanting DES (HR 3.83; 95 CI 1.14-12.9, P = 0.029). Late lumen loss suggesting neointimal growth after DES implantation was 0.28 ± 0.70 mm in the non-AVC group and 0.64 ± 0.90 mm in the AVC group (P = 0.013).Conclusions. AVC provides predictive information regarding DES implantation in patients on maintenance HD.",
author = "Hideki Ishii and Yoshitake Kumada and Takanobu Toriyama and Toru Aoyama and Hiroshi Takahashi and Tetsuya Amano and Yoshinari Yasuda and Yukio Yuzawa and Syoichi Maruyama and Seiichi Matsuo and Tatsuaki Matsubara and Toyoaki Murohara",
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Ishii, H, Kumada, Y, Toriyama, T, Aoyama, T, Takahashi, H, Amano, T, Yasuda, Y, Yuzawa, Y, Maruyama, S, Matsuo, S, Matsubara, T & Murohara, T 2009, 'Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis', Nephrology Dialysis Transplantation, vol. 24, no. 5, pp. 1562-1567. https://doi.org/10.1093/ndt/gfn685

Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis. / Ishii, Hideki; Kumada, Yoshitake; Toriyama, Takanobu; Aoyama, Toru; Takahashi, Hiroshi; Amano, Tetsuya; Yasuda, Yoshinari; Yuzawa, Yukio; Maruyama, Syoichi; Matsuo, Seiichi; Matsubara, Tatsuaki; Murohara, Toyoaki.

In: Nephrology Dialysis Transplantation, Vol. 24, No. 5, 01.05.2009, p. 1562-1567.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis

AU - Ishii, Hideki

AU - Kumada, Yoshitake

AU - Toriyama, Takanobu

AU - Aoyama, Toru

AU - Takahashi, Hiroshi

AU - Amano, Tetsuya

AU - Yasuda, Yoshinari

AU - Yuzawa, Yukio

AU - Maruyama, Syoichi

AU - Matsuo, Seiichi

AU - Matsubara, Tatsuaki

AU - Murohara, Toyoaki

PY - 2009/5/1

Y1 - 2009/5/1

N2 - Background. Even in the drug-eluting stent (DES) era, the restenosis rate of the follow-up period after percutaneous coronary intervention (PCI) is higher in haemodialysis (HD) patients than in non-HD patients. Therefore, higher restenosis remains a clinical limitation in HD patients, and a simple clinical method to predict patients likely to have restenosis after stent implantation is attractive. The present study investigated the potential relationship between aortic valvular calcification (AVC) and angiographical restenosis at follow-up after DES implantation in patients on maintenance HD.Methods. In the study, 97 patients were enrolled. We prospectively performed echocardiography before elective PCI with DES implantation. Angiographic follow-up was scheduled between 6 and 8 months after PCI. Restenosis at follow-up was defined as a diameter stenosis of ≥50 by measuring quantitative coronary angiography.Results. Of the enrolled patients, 59 patients (60.8) had AVC. Complete angiographical follow-up was obtained in 86 patients (88.7). The angiographical restenosis rate during the follow-up period was 24.7 in patients with AVC and 8.9 in patients without AVC hazard ratio (HR) 3.36; 95 confidence interval (CI) 1.18-9.56, P = 0.023. Even after multivariate adjustment including covariates related to atherogenecity, AVC remained an independent predictor of restenosis after implanting DES (HR 3.83; 95 CI 1.14-12.9, P = 0.029). Late lumen loss suggesting neointimal growth after DES implantation was 0.28 ± 0.70 mm in the non-AVC group and 0.64 ± 0.90 mm in the AVC group (P = 0.013).Conclusions. AVC provides predictive information regarding DES implantation in patients on maintenance HD.

AB - Background. Even in the drug-eluting stent (DES) era, the restenosis rate of the follow-up period after percutaneous coronary intervention (PCI) is higher in haemodialysis (HD) patients than in non-HD patients. Therefore, higher restenosis remains a clinical limitation in HD patients, and a simple clinical method to predict patients likely to have restenosis after stent implantation is attractive. The present study investigated the potential relationship between aortic valvular calcification (AVC) and angiographical restenosis at follow-up after DES implantation in patients on maintenance HD.Methods. In the study, 97 patients were enrolled. We prospectively performed echocardiography before elective PCI with DES implantation. Angiographic follow-up was scheduled between 6 and 8 months after PCI. Restenosis at follow-up was defined as a diameter stenosis of ≥50 by measuring quantitative coronary angiography.Results. Of the enrolled patients, 59 patients (60.8) had AVC. Complete angiographical follow-up was obtained in 86 patients (88.7). The angiographical restenosis rate during the follow-up period was 24.7 in patients with AVC and 8.9 in patients without AVC hazard ratio (HR) 3.36; 95 confidence interval (CI) 1.18-9.56, P = 0.023. Even after multivariate adjustment including covariates related to atherogenecity, AVC remained an independent predictor of restenosis after implanting DES (HR 3.83; 95 CI 1.14-12.9, P = 0.029). Late lumen loss suggesting neointimal growth after DES implantation was 0.28 ± 0.70 mm in the non-AVC group and 0.64 ± 0.90 mm in the AVC group (P = 0.013).Conclusions. AVC provides predictive information regarding DES implantation in patients on maintenance HD.

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U2 - 10.1093/ndt/gfn685

DO - 10.1093/ndt/gfn685

M3 - Article

C2 - 19075193

AN - SCOPUS:65249108658

VL - 24

SP - 1562

EP - 1567

JO - Nephrology Dialysis Transplantation

JF - Nephrology Dialysis Transplantation

SN - 0931-0509

IS - 5

ER -