Sirolimus vs. paclitaxel-eluting stent to coronary intervention in dialysis patients

Background: Patients on maintenance hemodialysis (HD) are at high risk for restenosis after percutaneous coronary intervention (PCI) even if treated with a sirolimus-eluting stent (SES). The aim of this study was to compare the effects of SES and paclitaxel-eluting stent (PES) in preventing restenosis in HD patients with coronary artery disease. Methods: A total of 100 consecutive patients on HD who underwent PCI were enrolled into the study. They were randomly assigned to receive either SES or PES. We compared follow-up angiographic outcomes between the SES and PES groups at 8-month follow-up. Results: The angiographical restenosis rate, defined as % diameter stenosis > 50% at 8-month follow-up, was 19.7% in the SES group and 20.0% in the PES group (p = 0.97). Late loss was also similar between the two groups (0.49 ± 0.70 mm vs. 0.48 ± 0.91 mm, P = 0.94). There were no significant differences in the rates of all-cause death, non-fatal myocardial infarction, or TLR due to stent restenosis-induced ischemia between the two groups (2.0% vs. 4.0%, p = 0.56, 2.0% vs. 4.0%, p = 0.56, and 16.0% vs. 12.0%, p = 0.57, respectively). Conclusions: There was no significant difference in angiographical outcome at 8-month follow-up between HD patients treated with SES and PES. Even if treated with DES including SES and PES, patients on HD are at high risk of restenosis after PCI.