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J Interv Cardiol ; 31(2): 170-176, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29166699

ABSTRACT

BACKGROUNDS: New-generation bioresorbable polymer-everolimus eluting stents (BP-EES) are available. This study aimed to compare the clinical outcomes for BP-EES compared to more established stent designs, namely the platinum chromium-EES (PtCr-EES) and cobalt chrome-EES(CoCr-EES) in patients with the end-stage chronic kidney disease (CKD) including hemodialysis (HD). METHODS: One-hundred-forty-one consecutive stents (BP-EES [n = 44], PtCr-EES [n = 45], and CoCr-EES [n = 52]) were implanted in 104 patients with CKD. All patients underwent a follow-up coronary angiography at 12 months after implantation. End-stage CKD was defined as an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 , or the need for HD. The following outcome variables were compared among the three stent groups after implantation and the 12-month follow-up: target lesion revascularization (TLR), stent thrombosis (ST), and major adverse cardiac event (MACE). Minimal stent diameter (MSD) and %diameter-stenosis (%DS) were measured using quantitative coronary angiography. RESULTS: The overall rate of TLR and MACE was 14.6% and 30.8%, respectively, with no incidence of ST. Immediately after implantation, the MSD (P = 0.22) and %DS (P = 0.42) were equivalent among the three groups. However, at the 12-month follow-up, a tendency towards higher TLR was observed for the BP-EES group (22.7%) compared with the PtCr-EES (8.8%) and CoCr-EES (9.6%) groups (P = 0.07). Late loss in lumen diameter was also significantly greater for the BP-EES (0.51 ± 0.64 mm) group than either the PtCr-EES (0.20 ± 0.61 mm) and CoCr-EES (0.25 ± 0.70 mm) groups (P = 0.03). CONCLUSIONS: BP-EES might increase the risk of in-stent restenosis in patients with end-stage of CKD or the need for HD.


Subject(s)
Chromium/therapeutic use , Cobalt/therapeutic use , Coronary Artery Disease , Coronary Restenosis , Coronary Vessels , Everolimus/therapeutic use , Kidney Failure, Chronic , Percutaneous Coronary Intervention/adverse effects , Platinum/therapeutic use , Absorbable Implants/standards , Aged , Coronary Angiography/methods , Coronary Artery Disease/complications , Coronary Artery Disease/surgery , Coronary Restenosis/diagnosis , Coronary Restenosis/epidemiology , Coronary Vessels/diagnostic imaging , Coronary Vessels/surgery , Drug-Eluting Stents/standards , Female , Follow-Up Studies , Humans , Immunosuppressive Agents/therapeutic use , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/diagnosis , Kidney Failure, Chronic/therapy , Male , Middle Aged , Percutaneous Coronary Intervention/methods , Renal Dialysis/methods , Risk Factors , Trace Elements/therapeutic use , Treatment Outcome
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