Coronary stenting does not improve the long-term cardiovascular outcome of patients with mild to moderate renal insufficiency / 中华医学杂志(英文版)
Chinese Medical Journal
;
(24): 158-164, 2009.
Article
in English
| WPRIM
| ID: wpr-311899
ABSTRACT
<p><b>BACKGROUND</b>Several studies have shown that coronary stenting reduces the frequency of clinical and angiographic restenosis in patients with mild to moderate renal insufficiency. However, less is known about the long-term benefits of stent use in this population. This study was aimed to determine the impact of coronary stenting on extended (5 years) long-term outcomes of patients with chronic renal insufficiency.</p><p><b>METHODS</b>The study included 602 consecutive patients who underwent successful percutaneous coronary intervention with stenting. Renal insufficiency was defined as an estimated glomerular filtration rate < 60 ml x min(-1) x 1.73 m(-2). The major adverse cardiac events were compared for patients with (n = 160) and without (n = 442) renal insufficiency.</p><p><b>RESULTS</b>After the third year of follow-up, nonfatal myocardial infarction and revascularization rates were significantly increased in patients with renal insufficiency compared with those without renal dysfunction (16.9% vs 7.7%, P = 0.001; 29.4% vs 15.8%, P < 0.001). In patients who had recurrent cardiovascular events, a significantly higher rate of de novo stenosis revascularization was found in patients with renal insufficiency than without renal insufficiency (57.7% vs 22.7%, P < 0.001), while there was no significant difference in target lesion revascularization between the groups (51.9% vs 43.6%, P = 0.323). Multivariate analysis demonstrated an independent impact of the presence of renal insufficiency on the major adverse cardiac events (hazard ratio 1.488, 95% confidence interval 1.051 - 2.106, P = 0.025) and de novo stenosis (hazard ratio 5.505, 95% confidence interval 2.151 - 14.090, P < 0.001).</p><p><b>CONCLUSIONS</b>The late major adverse cardiac events, after successful coronary stenting, is increased in patients with an estimated glomerular filtration rate < 60 ml x min(-1) x 1.73 m(-2). This might be associated with increased risk of de novo stenosis in this population.</p>
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Pathology
/
Therapeutics
/
Angioplasty, Balloon, Coronary
/
Stents
/
Coronary Angiography
/
Coronary Restenosis
/
Renal Insufficiency
/
Glomerular Filtration Rate
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Chinese Medical Journal
Year:
2009
Type:
Article
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