The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents.
Renal impairment (RI) is associated with impaired prognosis in patients with coronary artery disease. Clinical and angiographic outcomes of patients undergoing percutaneous coronary intervention (PCI) with the use of drug-eluting stents (DES) in this patient population are not well established.We po...
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doaj-8fa558dcbc324d26ad4a8f92dc2730012020-11-24T20:45:28ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0199e10645010.1371/journal.pone.0106450The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents.Giulio G StefaniniMasanori TaniwakiBindu KalesanLorenz RäberStefan StorteckyThomas PilgrimYoshinobu OnumaSigmund SilberPatrick W SerruysBernhard MeierPeter JüniStephan WindeckerRenal impairment (RI) is associated with impaired prognosis in patients with coronary artery disease. Clinical and angiographic outcomes of patients undergoing percutaneous coronary intervention (PCI) with the use of drug-eluting stents (DES) in this patient population are not well established.We pooled individual data for 5,011 patients from 3 trials with the exclusive and unrestricted use of DES (SIRTAX - N = 1,012, LEADERS - N = 1,707, RESOLUTE AC - N = 2,292). Angiographic follow-up was available for 1,544 lesions. Outcomes through 2 years were stratified according to glomerular filtration rate (normal renal function: GFR ≥ 90 ml/min; mild RI: 90<GFR ≥ 60 ml/min; moderate/severe RI GFR<60 ml/min).Patients with moderate/severe RI had an increased risk of cardiac death or myocardial infarction ([MI], OR 2.14, 95%CI 1.36-3.36), cardiac death (OR 2.21, 95%CI 1.10-4.46), and MI (OR 2.02, 95%CI 1.19-3.43) compared with patients with normal renal function at 2 years follow-up. There was no difference in cardiac death or MI between patients with mild RI compared to those with normal renal function (OR 1.10, 95%CI 0.75-1.61). The risk of target-lesion revascularization was similar for patients with moderate/severe RI (OR 1.17, 95%CI 0.70-1.95) and mild RI (OR 1.16, 95%CI 0.81-1.64) compared with patients with normal renal function. In-stent late loss and in-segment restenosis were not different for patients with moderate/severe RI, mild RI, and normal renal function.Renal function does not affect clinical and angiographic effectiveness of DES. However, prognosis remains impaired among patients with moderate/severe RI.http://europepmc.org/articles/PMC4153613?pdf=render |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Giulio G Stefanini Masanori Taniwaki Bindu Kalesan Lorenz Räber Stefan Stortecky Thomas Pilgrim Yoshinobu Onuma Sigmund Silber Patrick W Serruys Bernhard Meier Peter Jüni Stephan Windecker |
spellingShingle |
Giulio G Stefanini Masanori Taniwaki Bindu Kalesan Lorenz Räber Stefan Stortecky Thomas Pilgrim Yoshinobu Onuma Sigmund Silber Patrick W Serruys Bernhard Meier Peter Jüni Stephan Windecker The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. PLoS ONE |
author_facet |
Giulio G Stefanini Masanori Taniwaki Bindu Kalesan Lorenz Räber Stefan Stortecky Thomas Pilgrim Yoshinobu Onuma Sigmund Silber Patrick W Serruys Bernhard Meier Peter Jüni Stephan Windecker |
author_sort |
Giulio G Stefanini |
title |
The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. |
title_short |
The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. |
title_full |
The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. |
title_fullStr |
The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. |
title_full_unstemmed |
The impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. |
title_sort |
impact of renal impairment on long-term safety and effectiveness of drug-eluting stents. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2014-01-01 |
description |
Renal impairment (RI) is associated with impaired prognosis in patients with coronary artery disease. Clinical and angiographic outcomes of patients undergoing percutaneous coronary intervention (PCI) with the use of drug-eluting stents (DES) in this patient population are not well established.We pooled individual data for 5,011 patients from 3 trials with the exclusive and unrestricted use of DES (SIRTAX - N = 1,012, LEADERS - N = 1,707, RESOLUTE AC - N = 2,292). Angiographic follow-up was available for 1,544 lesions. Outcomes through 2 years were stratified according to glomerular filtration rate (normal renal function: GFR ≥ 90 ml/min; mild RI: 90<GFR ≥ 60 ml/min; moderate/severe RI GFR<60 ml/min).Patients with moderate/severe RI had an increased risk of cardiac death or myocardial infarction ([MI], OR 2.14, 95%CI 1.36-3.36), cardiac death (OR 2.21, 95%CI 1.10-4.46), and MI (OR 2.02, 95%CI 1.19-3.43) compared with patients with normal renal function at 2 years follow-up. There was no difference in cardiac death or MI between patients with mild RI compared to those with normal renal function (OR 1.10, 95%CI 0.75-1.61). The risk of target-lesion revascularization was similar for patients with moderate/severe RI (OR 1.17, 95%CI 0.70-1.95) and mild RI (OR 1.16, 95%CI 0.81-1.64) compared with patients with normal renal function. In-stent late loss and in-segment restenosis were not different for patients with moderate/severe RI, mild RI, and normal renal function.Renal function does not affect clinical and angiographic effectiveness of DES. However, prognosis remains impaired among patients with moderate/severe RI. |
url |
http://europepmc.org/articles/PMC4153613?pdf=render |
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