Abstract
Background - Percutaneous coronary intervention (PCI) using drug-eluting stents significantly reduces the risk of restenosis in the general population. However, in patients on hemodialysis, adverse cardiac events are frequently seen even if treated with drug-eluting stents. Recent studies suggest that C-reactive protein (CRP) reflects vascular wall inflammation and can predict adverse cardiac events. We evaluated possible prognostic values of CRP on outcomes in patients on hemodialysis undergoing PCI with drug eluting stents. Methods and Results - A total of 167 patients undergoing PCI with sirolimus-eluting stents for stable angina (322 lesions) were enrolled. They were divided into tertiles according to serum CRP levels. We analyzed the incidence of major adverse cardiovascular events including cardiovascular death, nonfatal myocardial infarction, and target lesion revascularization after PCI as well as quantitative coronary angiographic data. The mean follow-up was 31 months (SD, 14). Major adverse cardiac events occurred in 11 patients (19.6%) of the lowest tertile, in 22 patients (39.3%) of the middle tertile, and in 28 patients (50.9%) of the highest tertile during follow-up period (P=0.0009). There was a progressive increase in neointimal growth after sirolimus-eluting stent implantation during follow-up because preprocedural CRP levels were higher, despite similar angiographic data just after PCI. Angiographic restenosis at 6 to 8 months after PCI was seen in 10.6% in the lowest tertile, 17.9% in the middle tertile, and 32.0% in the highest tertile (P=0.0007). Conclusions - Increased preprocedural serum CRP levels would predict higher major adverse cardiac events and restenosis rates after sirolimus-eluting stents implantation in patients on hemodialysis.
| Original language | English |
|---|---|
| Pages (from-to) | 513-518 |
| Number of pages | 6 |
| Journal | Circulation: Cardiovascular Interventions |
| Volume | 2 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 01-12-2009 |
| Externally published | Yes |
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All Science Journal Classification (ASJC) codes
- Cardiology and Cardiovascular Medicine
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Prognostic values of C-reactive protein levels on clinical outcome after mplantation of sirolimus-eluting stents in patients on hemodialysise. / Ishii, Hideki; Toriyama, Takanobu; Aoyama, Toru; Takahashi, Hiroshi; Amano, Tetsuya; Hayashi, Mutsuharu; Tanaka, Miho; Kawamura, Yoshihiro; Yasuda, Yoshinari; Yuzawa, Yukio; Maruyama, Shoichi; Matsuo, Seiichi; Matsubara, Tatsuaki; Murohara, Toyoaki.
In: Circulation: Cardiovascular Interventions, Vol. 2, No. 6, 01.12.2009, p. 513-518.Research output: Contribution to journal › Article
TY - JOUR
T1 - Prognostic values of C-reactive protein levels on clinical outcome after mplantation of sirolimus-eluting stents in patients on hemodialysise
AU - Ishii, Hideki
AU - Toriyama, Takanobu
AU - Aoyama, Toru
AU - Takahashi, Hiroshi
AU - Amano, Tetsuya
AU - Hayashi, Mutsuharu
AU - Tanaka, Miho
AU - Kawamura, Yoshihiro
AU - Yasuda, Yoshinari
AU - Yuzawa, Yukio
AU - Maruyama, Shoichi
AU - Matsuo, Seiichi
AU - Matsubara, Tatsuaki
AU - Murohara, Toyoaki
PY - 2009/12/1
Y1 - 2009/12/1
N2 - Background - Percutaneous coronary intervention (PCI) using drug-eluting stents significantly reduces the risk of restenosis in the general population. However, in patients on hemodialysis, adverse cardiac events are frequently seen even if treated with drug-eluting stents. Recent studies suggest that C-reactive protein (CRP) reflects vascular wall inflammation and can predict adverse cardiac events. We evaluated possible prognostic values of CRP on outcomes in patients on hemodialysis undergoing PCI with drug eluting stents. Methods and Results - A total of 167 patients undergoing PCI with sirolimus-eluting stents for stable angina (322 lesions) were enrolled. They were divided into tertiles according to serum CRP levels. We analyzed the incidence of major adverse cardiovascular events including cardiovascular death, nonfatal myocardial infarction, and target lesion revascularization after PCI as well as quantitative coronary angiographic data. The mean follow-up was 31 months (SD, 14). Major adverse cardiac events occurred in 11 patients (19.6%) of the lowest tertile, in 22 patients (39.3%) of the middle tertile, and in 28 patients (50.9%) of the highest tertile during follow-up period (P=0.0009). There was a progressive increase in neointimal growth after sirolimus-eluting stent implantation during follow-up because preprocedural CRP levels were higher, despite similar angiographic data just after PCI. Angiographic restenosis at 6 to 8 months after PCI was seen in 10.6% in the lowest tertile, 17.9% in the middle tertile, and 32.0% in the highest tertile (P=0.0007). Conclusions - Increased preprocedural serum CRP levels would predict higher major adverse cardiac events and restenosis rates after sirolimus-eluting stents implantation in patients on hemodialysis.
AB - Background - Percutaneous coronary intervention (PCI) using drug-eluting stents significantly reduces the risk of restenosis in the general population. However, in patients on hemodialysis, adverse cardiac events are frequently seen even if treated with drug-eluting stents. Recent studies suggest that C-reactive protein (CRP) reflects vascular wall inflammation and can predict adverse cardiac events. We evaluated possible prognostic values of CRP on outcomes in patients on hemodialysis undergoing PCI with drug eluting stents. Methods and Results - A total of 167 patients undergoing PCI with sirolimus-eluting stents for stable angina (322 lesions) were enrolled. They were divided into tertiles according to serum CRP levels. We analyzed the incidence of major adverse cardiovascular events including cardiovascular death, nonfatal myocardial infarction, and target lesion revascularization after PCI as well as quantitative coronary angiographic data. The mean follow-up was 31 months (SD, 14). Major adverse cardiac events occurred in 11 patients (19.6%) of the lowest tertile, in 22 patients (39.3%) of the middle tertile, and in 28 patients (50.9%) of the highest tertile during follow-up period (P=0.0009). There was a progressive increase in neointimal growth after sirolimus-eluting stent implantation during follow-up because preprocedural CRP levels were higher, despite similar angiographic data just after PCI. Angiographic restenosis at 6 to 8 months after PCI was seen in 10.6% in the lowest tertile, 17.9% in the middle tertile, and 32.0% in the highest tertile (P=0.0007). Conclusions - Increased preprocedural serum CRP levels would predict higher major adverse cardiac events and restenosis rates after sirolimus-eluting stents implantation in patients on hemodialysis.
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U2 - 10.1161/CIRCINTERVENTIONS.109.889915
DO - 10.1161/CIRCINTERVENTIONS.109.889915
M3 - Article
VL - 2
SP - 513
EP - 518
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
SN - 1941-7640
IS - 6
ER -