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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 J+Am+Coll+Cardiol
2016 ; 67
(12
): 1459-1469
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Drug-Eluting Versus Bare-Metal Stents During PCI in Patients With End-Stage Renal
Disease on Dialysis
#MMPMID27012407
Chang TI
; Montez-Rath ME
; Tsai TT
; Hlatky MA
; Winkelmayer WC
J Am Coll Cardiol
2016[Mar]; 67
(12
): 1459-1469
PMID27012407
show ga
BACKGROUND: In patients undergoing percutaneous coronary intervention (PCI),
drug-eluting stents (DES) reduce repeat revascularizations compared with
bare-metal stents (BMS), but their effects on death and myocardial infarction
(MI) are mixed. Few studies have focused on patients with end-stage renal
disease. OBJECTIVES: This study compared mortality and cardiovascular morbidity
during percutaneous coronary intervention with DES and with BMS in dialysis
patients. METHODS: We identified 36,117 dialysis patients from the USRDS (United
States Renal Data System) who had coronary stenting in the United States between
April 23, 2003, and December 31, 2010, and examined the association of DES versus
BMS with 1-year outcomes: death; death or MI; and death, MI, or repeat
revascularization. We also conducted a temporal analysis by dividing the study
period into 3 DES eras: Transitional (April 23, 2003, to June 30, 2004); Liberal
(July 1, 2004, to December 31, 2006); and Selective (January 1, 2007, to December
31, 2010). RESULTS: One-year event rates were high, with 38 deaths; 55 death or
MI events; and 71 death, MI, or repeat revascularization events per 100
person-years. DES, compared with BMS, were associated with a significant 18%
lower risk of death; 16% lower risk of death or MI; and 13% lower risk of death,
MI, or repeat revascularization. DES use varied, from 56% in the Transitional era
to 85% in the Liberal era and 62% in the Selective era. DES outcomes in the
Liberal era were significantly better than in the Transitional Era, but not
significantly better than in the Selective Era. CONCLUSIONS: DES for percutaneous
coronary intervention appears to be safe for use in U.S. dialysis patients and is
associated with lower rates of death, MI, and repeat revascularization.