Impact of chronic kidney disease on a re-percutaneous coronary intervention for sirolimus-eluting stent restenosis

Yutaka Aoyama, Haruo Hirayama, Hideki Ishii, Koichi Kobayashi, Kiyotake Ishikawa, Masateru Takigawa, Mamoru Nanasato, Yukihiko Yoshida, Toru Aoyama, Daiji Yoshikawa, Tatsuaki Matsubara, Toyoaki Murohara

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Objectives: Recurrent in-stent restenosis remains an important clinical issue after a percutaneous coronary intervention even after treatment with a sirolimus-eluting stent (SES) especially in patients with chronic kidney disease. We evaluated the impact of renal insufficiency on the clinical and angiographic outcomes after treatment for SES restenosis. Methods and Results: A total of 74 patients with 76 lesions underwent subsequent revascularization with a drug-eluting stent for SES restenosis. Patients were classified into three groups: group 1 included 29 patients with an estimated glomerular filtration rate more than 60 ml/min/1.73 m; group 2 included 27 patients with lower estimated glomerular filtration rate (<60 ml/min/1.73 m) without hemodialysis (HD) dependence; and group 3 included 18 patients on HD. Clinical and angiographic follow-up was carried out at 8 months. Late lumen loss at the 8-month follow-up angiography showed progressive increases from group 1 to 2 to 3 (group 1: 0.36±0.39 mm, group 2: 1.11±0.61 mm, group 3: 1.30±0.85 mm, P<0.001). Similarly, compared with group 1, groups 2 and 3 had significantly higher rates of major adverse cardiac events (6.9, 37.0, and 38.9%, respectively, P=0.001), primarily because of a high frequency of target lesion revascularization (8.0, 34.8, and 33.3%, respectively, P=0.019). Conclusion: Non-HD-dependent chronic kidney disease patients had increased neointimal growth in the follow-up phase after percutaneous coronary intervention, with a drug-eluting stent for SES restenosis almost equivalent to patients on HD, resulting in higher rates of recurrent restenosis than patients with preserved renal function.

Original languageEnglish
Pages (from-to)528-532
Number of pages5
JournalCoronary Artery Disease
Volume23
Issue number8
DOIs
Publication statusPublished - 01-12-2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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