Impact of chronic kidney disease on clinical and angiographic results following implantation of sirolimus-eluting coronary stents

Abstract

Although sirolimus-eluting stent (SES) is effective to reduce restenosis, the effect of SES for patients with chronic kidney disease (CKD) has been ambiguous. SES were exclusively implanted into 304 lesions in 195 patients. Forty-seven percent of the patients had diabetes. Patients were divided into three groups by estimated glomerular filtration rate, CKD stage 0-2: 156 patients, 239 lesions; CKD stage 3-4: 21 patients, 37 lesions; and CKD stage 5: 18 patients, 28 lesions. Clinical follow-up data were available in 97% at 616 ± 192 days. There was a statistically significant association between the stage of CKD and target lesion revascularization (TLR) (CKD 0-2: 2.7%, CKD 3-4: 5.3%, and CKD 5: 11.9%; P = 0.011), and late lumen loss at 8 months (CKD 0-2: 0.13 ± 0.25 mm, CKD 3-4: 0.27 ± 0.47 mm, and CKD 5: 0.37 ± 0.61 mm; P = 0.0032). The frequency of clinical adverse events was also higher according to stages of CKD. In conclusion, stages of CKD proportionally correlated with TLR, late lumen loss and major adverse cardiac events following SES implantation.

Clinical Outcome of Low Dose Contrast during Percutaneous Coronary Intervention in Patients with Moderate to Severe Kidney Impairment

“…Contrast-induced acute kidney injury (CI-AKI) is one of the complications following coronary angiography (CAG) and percutaneous coronary intervention (PCI), especially among patients with chronic kidney disease [1]. CI-AKI after PCI has a poor prognosis and is at high risk for major adverse cardiac and cerebrovascular events (MACCE) in the long-term clinical course [2] [3] [4] [5].…”