Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients

Kaoru Yasuda, Hirotake Kasuga, Toru Aoyama, Hiroshi Takahashi, Takanobu Toriyama, Yasumasa Kawade, Shigejiro Iwashima, Shigeki Yamada, Hirohisa Kawahara, Shoichi Maruyama, Yukio Yuzawa, Hideki Ishii, Toyoaki Murohara, Seiichi Matsuo

研究成果: Article

40 引用 (Scopus)

抄録

It has been reported that percutaneous coronary intervention (PCI) is beneficial for coronary artery disease (CAD) among the general population. However, its effects in patients who are on hemodialysis (HD) remain: unclear. A prospective cohort study was performed to clarify whether PCI has a therapeutic advantage over medical therapy among HD patients with CAD. A follow-up study to 5 yr was conducted among 259 HD patients with ischemic heart disease. Mean follow-up was 39 mo. Patients were divided into three groups: 122 patients without significant stenosis, 88 patients who had significant stenosis and were treated with PCI, and 49 patients who had significant stenosis and were treated with medication only. The primary end point was cardiac death, and the secondary end point was all-cause death. The results showed that the 5-yr cardiac survival rate was 41.6% in the medication group, 77.1% in the PCI group (P = 0.0006), and 84.5% in the nonstenosis group (P < 0.0001). The 5-yr all-cause survival rate was 19.3% in the medication group, 48.4% in the PCI group (P = 0.004), and 64.3% in the nonstenosis group (P < 0.0001). Even after adjustment for other risk factors, effects of PCI on the risk for cardiac and all-cause death remained significant and independent (odds ratio 0.14; 95% confidence interval 0.08 to 0.25, P = 0.0006; and odds ratio 0.37; 95% confidence interval 0.26 to 0.54, P = 0.0062, respectively). Results were consistent when the therapeutic effect of PCI or medication was analyzed using propensity-matched patients. These data suggested that PCI could improve the prognosis of HD patients with CAD. PCI would be recommended for HD patients with CAD.

元の言語English
ページ(範囲)2322-2332
ページ数11
ジャーナルJournal of the American Society of Nephrology
17
発行部数8
DOI
出版物ステータスPublished - 01-08-2006

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Percutaneous Coronary Intervention
Renal Dialysis
Coronary Artery Disease
Therapeutics
Pathologic Constriction
Cause of Death
Survival Rate
Odds Ratio
Confidence Intervals
Therapeutic Uses
Myocardial Ischemia
Cohort Studies
Prospective Studies

All Science Journal Classification (ASJC) codes

  • Nephrology

これを引用

Yasuda, Kaoru ; Kasuga, Hirotake ; Aoyama, Toru ; Takahashi, Hiroshi ; Toriyama, Takanobu ; Kawade, Yasumasa ; Iwashima, Shigejiro ; Yamada, Shigeki ; Kawahara, Hirohisa ; Maruyama, Shoichi ; Yuzawa, Yukio ; Ishii, Hideki ; Murohara, Toyoaki ; Matsuo, Seiichi. / Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients. :: Journal of the American Society of Nephrology. 2006 ; 巻 17, 番号 8. pp. 2322-2332.
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title = "Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients",
abstract = "It has been reported that percutaneous coronary intervention (PCI) is beneficial for coronary artery disease (CAD) among the general population. However, its effects in patients who are on hemodialysis (HD) remain: unclear. A prospective cohort study was performed to clarify whether PCI has a therapeutic advantage over medical therapy among HD patients with CAD. A follow-up study to 5 yr was conducted among 259 HD patients with ischemic heart disease. Mean follow-up was 39 mo. Patients were divided into three groups: 122 patients without significant stenosis, 88 patients who had significant stenosis and were treated with PCI, and 49 patients who had significant stenosis and were treated with medication only. The primary end point was cardiac death, and the secondary end point was all-cause death. The results showed that the 5-yr cardiac survival rate was 41.6{\%} in the medication group, 77.1{\%} in the PCI group (P = 0.0006), and 84.5{\%} in the nonstenosis group (P < 0.0001). The 5-yr all-cause survival rate was 19.3{\%} in the medication group, 48.4{\%} in the PCI group (P = 0.004), and 64.3{\%} in the nonstenosis group (P < 0.0001). Even after adjustment for other risk factors, effects of PCI on the risk for cardiac and all-cause death remained significant and independent (odds ratio 0.14; 95{\%} confidence interval 0.08 to 0.25, P = 0.0006; and odds ratio 0.37; 95{\%} confidence interval 0.26 to 0.54, P = 0.0062, respectively). Results were consistent when the therapeutic effect of PCI or medication was analyzed using propensity-matched patients. These data suggested that PCI could improve the prognosis of HD patients with CAD. PCI would be recommended for HD patients with CAD.",
author = "Kaoru Yasuda and Hirotake Kasuga and Toru Aoyama and Hiroshi Takahashi and Takanobu Toriyama and Yasumasa Kawade and Shigejiro Iwashima and Shigeki Yamada and Hirohisa Kawahara and Shoichi Maruyama and Yukio Yuzawa and Hideki Ishii and Toyoaki Murohara and Seiichi Matsuo",
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Yasuda, K, Kasuga, H, Aoyama, T, Takahashi, H, Toriyama, T, Kawade, Y, Iwashima, S, Yamada, S, Kawahara, H, Maruyama, S, Yuzawa, Y, Ishii, H, Murohara, T & Matsuo, S 2006, 'Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients', Journal of the American Society of Nephrology, 巻. 17, 番号 8, pp. 2322-2332. https://doi.org/10.1681/ASN.2005090958

Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients. / Yasuda, Kaoru; Kasuga, Hirotake; Aoyama, Toru; Takahashi, Hiroshi; Toriyama, Takanobu; Kawade, Yasumasa; Iwashima, Shigejiro; Yamada, Shigeki; Kawahara, Hirohisa; Maruyama, Shoichi; Yuzawa, Yukio; Ishii, Hideki; Murohara, Toyoaki; Matsuo, Seiichi.

:: Journal of the American Society of Nephrology, 巻 17, 番号 8, 01.08.2006, p. 2322-2332.

研究成果: Article

TY - JOUR

T1 - Comparison of percutaneous coronary intervention with medication in the treatment of coronary artery disease in hemodialysis patients

AU - Yasuda, Kaoru

AU - Kasuga, Hirotake

AU - Aoyama, Toru

AU - Takahashi, Hiroshi

AU - Toriyama, Takanobu

AU - Kawade, Yasumasa

AU - Iwashima, Shigejiro

AU - Yamada, Shigeki

AU - Kawahara, Hirohisa

AU - Maruyama, Shoichi

AU - Yuzawa, Yukio

AU - Ishii, Hideki

AU - Murohara, Toyoaki

AU - Matsuo, Seiichi

PY - 2006/8/1

Y1 - 2006/8/1

N2 - It has been reported that percutaneous coronary intervention (PCI) is beneficial for coronary artery disease (CAD) among the general population. However, its effects in patients who are on hemodialysis (HD) remain: unclear. A prospective cohort study was performed to clarify whether PCI has a therapeutic advantage over medical therapy among HD patients with CAD. A follow-up study to 5 yr was conducted among 259 HD patients with ischemic heart disease. Mean follow-up was 39 mo. Patients were divided into three groups: 122 patients without significant stenosis, 88 patients who had significant stenosis and were treated with PCI, and 49 patients who had significant stenosis and were treated with medication only. The primary end point was cardiac death, and the secondary end point was all-cause death. The results showed that the 5-yr cardiac survival rate was 41.6% in the medication group, 77.1% in the PCI group (P = 0.0006), and 84.5% in the nonstenosis group (P < 0.0001). The 5-yr all-cause survival rate was 19.3% in the medication group, 48.4% in the PCI group (P = 0.004), and 64.3% in the nonstenosis group (P < 0.0001). Even after adjustment for other risk factors, effects of PCI on the risk for cardiac and all-cause death remained significant and independent (odds ratio 0.14; 95% confidence interval 0.08 to 0.25, P = 0.0006; and odds ratio 0.37; 95% confidence interval 0.26 to 0.54, P = 0.0062, respectively). Results were consistent when the therapeutic effect of PCI or medication was analyzed using propensity-matched patients. These data suggested that PCI could improve the prognosis of HD patients with CAD. PCI would be recommended for HD patients with CAD.

AB - It has been reported that percutaneous coronary intervention (PCI) is beneficial for coronary artery disease (CAD) among the general population. However, its effects in patients who are on hemodialysis (HD) remain: unclear. A prospective cohort study was performed to clarify whether PCI has a therapeutic advantage over medical therapy among HD patients with CAD. A follow-up study to 5 yr was conducted among 259 HD patients with ischemic heart disease. Mean follow-up was 39 mo. Patients were divided into three groups: 122 patients without significant stenosis, 88 patients who had significant stenosis and were treated with PCI, and 49 patients who had significant stenosis and were treated with medication only. The primary end point was cardiac death, and the secondary end point was all-cause death. The results showed that the 5-yr cardiac survival rate was 41.6% in the medication group, 77.1% in the PCI group (P = 0.0006), and 84.5% in the nonstenosis group (P < 0.0001). The 5-yr all-cause survival rate was 19.3% in the medication group, 48.4% in the PCI group (P = 0.004), and 64.3% in the nonstenosis group (P < 0.0001). Even after adjustment for other risk factors, effects of PCI on the risk for cardiac and all-cause death remained significant and independent (odds ratio 0.14; 95% confidence interval 0.08 to 0.25, P = 0.0006; and odds ratio 0.37; 95% confidence interval 0.26 to 0.54, P = 0.0062, respectively). Results were consistent when the therapeutic effect of PCI or medication was analyzed using propensity-matched patients. These data suggested that PCI could improve the prognosis of HD patients with CAD. PCI would be recommended for HD patients with CAD.

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