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10.1016/j.jacc.2015.10.104

http://scihub22266oqcxt.onion/10.1016/j.jacc.2015.10.104
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suck abstract from ncbi


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pmid27012407
      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.
  • |*Renal Dialysis [MESH]
  • |*Stents [MESH]
  • |Cause of Death/trends [MESH]
  • |Coronary Artery Disease/complications/mortality/*surgery [MESH]
  • |Drug-Eluting Stents [MESH]
  • |Female [MESH]
  • |Follow-Up Studies [MESH]
  • |Humans [MESH]
  • |Incidence [MESH]
  • |Kidney Failure, Chronic/*complications/mortality/therapy [MESH]
  • |Male [MESH]
  • |Middle Aged [MESH]
  • |Percutaneous Coronary Intervention/*methods [MESH]
  • |Postoperative Complications/*epidemiology [MESH]
  • |Prognosis [MESH]
  • |Retrospective Studies [MESH]
  • |Risk Assessment/*methods [MESH]
  • |Risk Factors [MESH]
  • |Severity of Illness Index [MESH]
  • |Survival Rate/trends [MESH]
  • |Time Factors [MESH]


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