Impacto da insuficiência renal crônica na eficácia de stents farmacológicos: estudo de seguimento de longo prazo

Gomes, Vitor; Blaya, Patrícia; Lasevitch, Ricardo; Oliveira, Denise de; Hickmann, Patrícia; Smidt, Luis Felipe Silva; Polanczyk, Carísi Anne; Caramori, Paulo

doi:10.1590/s0066-782x2011005000045

Cited by 7 publications

(6 citation statements)

References 29 publications

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“…As observed in other studies, the incidence of adverse CV events during hospitalization was higher in CKD patients [12,17]. In the present study, patients with CKD more often had cardiogenic shock and cardiac arrest during hospitalization.…”

Section: Discussionsupporting

confidence: 87%

“…The following report revealed that a high proportion (17.3%) of patients hospitalized with ACS and DES implantation suffered from CKD, and confirmed previous data that CKD is a strong risk factor of death at the 12-month follow-up [11,12]. Furthermore, our study is the first to present that the introduction of DES-II did not bring benefit in CKD patients at the 12-month follow-up, which is a contrast to the non-CKD population [13].…”

Section: Discussionsupporting

confidence: 84%

“…Similarly to other studies, CKD patients in the presented registry carried a higher risk of adverse events, they were older [2,11,12,14,15,16], were more often females [11,14,16], and had a higher percentage of comorbidities, such as hypertension [11,14,15,16], diabetes [12,15,16], peripheral artery disease [11,16], and more severe CV disease [14,15]. …”

Section: Discussionsupporting

confidence: 58%

“…It is well proven that patients with CKD have a worse prognosis compared with patients with normal renal function [11,12]. As observed in other studies, the incidence of adverse CV events during hospitalization was higher in CKD patients [12,17].…”

Section: Discussionmentioning

confidence: 67%

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Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents

et al. 2016

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Background: The following registry (Katowice-Zabrze retrospective registry) aimed to assess the influence of a chronic kidney disease (CKD) on long-term clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) using either first-generation (DES-I) or second-generation (DES-II) drug-eluting stents. Methods: The study group consisted of 1,908 consecutive patients, of whom 331 (17.3%) had CKD. CKD was defined as an estimated glomerular filtration rate of <60 mL/min/m². We evaluated the major adverse cardiac and cerebral events (MACCE), i.e., the composite of death, myocardial infarction (MI), stroke, and target vessel revascularization at the 12-month follow-up. Results: CKD patients had a lower left ventricular ejection fraction and more often a history of MI and PCI. Coronary angiography revealed that multivessel coronary artery disease, intracoronary thrombus, and extensive calcifications were more frequent in patients with CKD. However, the SYNTAX score did not vary between patients with or without CKD. There was a higher rate of in-hospital bleedings requiring blood transfusion in patients with CKD. At the 1-year follow-up, MACCE (17.8 vs. 12.6%, HR = 1.46 [95% CI 1.05-2.03], p = 0.009) and death (8.4 vs. 2.3%, HR = 3.9 [95% CI 2.0-7.5], p < 0.001) were more often observed in CKD patients. Multivariable Cox analysis revealed that CKD was an independent risk predictor of death after PCI at the 1-year follow-up (HR = 2.1 [95% CI 1.2-3.6], p = 0.004). In comparison to DES-I, the use of DES-II did not decrease the adverse effect of CKD on MACCE. Conclusion: CKD patients had an increased risk of in-hospital bleeding requiring blood transfusion and a higher risk of MACCE and death at the 12-month follow-up. The use of second-generation DES did not improve clinical outcomes in patients with CKD at the 12-month follow-up.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 67%

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Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents

et al. 2016

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“…18,19 In patients with CKD, percutaneous coronary intervention with BMS carries an increased risk of restenosis and cardiac events when compared to those with normal renal function. 20 In contrast, when DES were used in CKD patients, there was no difference in rates of restenosis when compared to non-CKD patients, 19 suggesting that DES may be preferable in this group.…”

Section: Discussionmentioning

confidence: 99%

5 Years Experience With Drug Eluting and Bare Metal Stents as Primary Intervention in Transplant Renal Artery Stenosis

Estrada

Musani

Darras

et al. 2017

Transplantation Direct

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BackgroundTransplant renal artery stenosis (TRAS) is a common vascular complication after kidney transplantation and is associated with refractory hypertension, volume overload, and graft injury or loss. This article describes 5-year outcomes of endovascular intervention for TRAS with bare metal and drug eluting stents (DES).MethodsWe investigated, as a prospective cohort study, patient and graft outcomes after the targeted use of DES for vessel diameter less than 5 mm and bare metal stents (BMS) for vessel diameter greater than 5 mm as the primary management for TRAS.ResultsFrom March 2008 to November 2014, 57 patients were stented for hemodynamically significant TRAS; 29 received DES, 26 received BMS, and 2 patients received both stent types. They were followed up for a mean of 35.1 ± 22.8 months; a subset of these patients who all received DES were followed up for 61.7 ± 17.5 months. Mean serum creatinine declined from 2.87 ± 1.5 mg/dL at the time of intervention to 1.98 ± 0.76 mg/dL (P < 0.001) at one month follow-up and was 1.96 ±0.92 mg/dL (P < 0.001) at 35.1 ± 22.8 months. Mean systolic blood pressure declined from 159.05 ± 19.68 mm Hg at time of intervention to 135.65 ± 15.10 mm Hg (P < 0.001) at most recent visit. Clinically driven restenosis requiring repeat revascularization occurred in 15.7% of patients.ConclusionsPrimary stenting with DES and BMS is both successful in the initial treatment of TRAS and also produced an immediate and long-term reduction in serum creatinine and systolic blood pressure.

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Revascularization Strategies in CKD: Antiplatelet Therapy, Stent Type, Timing, and Complications of PCI

Qattan

Brar

2017

Cardio-Nephrology

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Impacto da insuficiência renal crônica na eficácia de stents farmacológicos: estudo de seguimento de longo prazo

Cited by 7 publications

References 29 publications

Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents

Long-Term Percutaneous Coronary Intervention Outcomes of Patients with Chronic Kidney Disease in the Era of Second-Generation Drug-Eluting Stents

5 Years Experience With Drug Eluting and Bare Metal Stents as Primary Intervention in Transplant Renal Artery Stenosis

Revascularization Strategies in CKD: Antiplatelet Therapy, Stent Type, Timing, and Complications of PCI

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