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Impact of chronic kidney disease on long‐term clinical outcomes of everolimus‐eluting stent implantation: A subanalysis of the Tokyo‐MD PCI registry
Author(s) -
Miyazaki Toru,
Ashikaga Takashi,
Asano Mitsutoshi,
Sasaoka Taro,
Kurihara Ken,
Yoshikawa Shunji,
Isobe Mitsuaki
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28070
Subject(s) - medicine , mace , hazard ratio , interquartile range , kidney disease , conventional pci , percutaneous coronary intervention , myocardial infarction , cardiology , drug eluting stent , stent , confidence interval , surgery
Objective The aim of the study was to investigate the impact of chronic kidney disease (CKD) on the 5‐year clinical outcomes of everolimus‐eluting stent (EES) implantation. Background Recent studies have demonstrated the safety and efficacy of EES. However, limited information exists on the long‐term clinical outcomes associated with CKD. Methods The Tokyo‐MD PCI study is a multi‐center observational study designed to describe the clinical outcomes of unselected patients after EES implantation. In this subanalysis, patients on maintenance hemodialysis were excluded, and patients with (n = 316) or without (n = 1,424) CKD were evaluated for their 5‐year incidence rates of major adverse cardiac events (MACEs), defined as death, non‐fatal myocardial infarction, ischemia driven target lesion revascularization (ID‐TLR), and stent thrombosis (ST). Results The mean and median follow‐up duration were 1,391 ± 557 days and 1,769 days (interquartile range, 1,012–1,800 days), respectively. Although the incidence of ID‐TLR and ST was similar between patients with and without CKD (4.9% vs. 3.7%, P = 0.26, 0.5% vs. 1.0%, P = 0.20, respectively), cardiac death and MACE were significantly higher in patients with CKD than in those without CKD (6.5% vs. 2.9%, P = 0.007, 26.9% vs. 14.0%, P < 0.001, respectively). In multivariate analysis, CKD was an independent predictor of MACE (hazard ratio 1.22 [95% confidence interval 1.04–1.43], P = 0.01). Conclusions Patients with CKD had similar ID‐TLR and ST rates as those without CKD at 5 years after EES implantation. The risk of long‐term MACEs appeared to be associated with CKD.