Background: Patients with chronic kidney disease (CKD) submitted to coronary angioplasty have higher rates of target lesion revascularization (TLR) and mortality. Drug-eluting stents (DES) are associated with a lower rate of restenosis, compared to bare metal stents (BMS), although data on DES efficacy and safety is limited in patients with CKD.
Background:Drug-eluting stents have been used in daily practice since 2002, with the clear
advantages of reducing the risk of target vessel revascularization and an
impressive reduction in restenosis rate by 50%-70%. However, the occurrence of a
late thrombosis can compromise long-term results, particularly if the risks of
this event were sustained. In this context, a registry of clinical cases gains
special value.Objective:To evaluate the efficacy and safety of drug-eluting stents in the real world.Methods:We report on the clinical findings and 8-year follow-up parameters of all patients
that underwent percutaneous coronary intervention with a drug-eluting stent from
January 2002 to April 2007. Drug-eluting stents were used in accordance with the
clinical and interventional cardiologist decision and availability of the
stent.Results:A total of 611 patients were included, and clinical follow-up of up to 8 years was
obtained for 96.2% of the patients. Total mortality was 8.7% and nonfatal
infarctions occurred in 4.3% of the cases. Target vessel revascularization
occurred in 12.4% of the cases, and target lesion revascularization occurred in 8%
of the cases. The rate of stent thrombosis was 2.1%. There were no new episodes of
stent thrombosis after the fifth year of follow-up. Comparative subanalysis showed
no outcome differences between the different types of stents used, including
Cypher®, Taxus®, and Endeavor®.Conclusion:These findings indicate that drug-eluting stents remain safe and effective at very
long-term follow-up. Patients in the "real world" may benefit from drug-eluting
stenting with excellent, long-term results.
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