Open AccessClinical Outcomes of Dialysis Patients Treated with Drug-Eluting Stent for Left Main Distal Bifurcation Lesions
Author(s) -
Watanabe Yusuke,
Mitomo Satoru,
Demir Ozan M.,
Liu Kuan-Liang,
Tung Ying-Chang,
Chieffo Alaide,
Montorfano Matteo,
Chang Chi-Jen,
Nakamura Sunao,
Colombo Antonio
Publication year - 2021
Publication title -
cardiorenal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.661
H-Index - 21
eISSN - 1664-5502
pISSN - 1664-3828
DOI - 10.1159/000510731
Subject(s) - research article
Aims: We assessed clinical outcomes after percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) distal bifurcation lesions using drug-eluting stents (DES) in hemodialysis (HD) patients compared to non-HD patients. Methods and Results: We identified 1,858 consecutive patients who underwent PCI for ULMCA distal bifurcation lesions at 4 high-volume centers in Japan, Italy, and Taiwan between January 2005 and December 2015. Of them, 1,416 patients were treated with DES including 113 HD patients and 1,303 non-HD patients. The primary end point was target lesion failure (TLF) defined as a composite of cardiac death, target lesion revascularization (TLR), and myocardial infarction. HD patients were more likely to be younger and have diabetes mellitus, dyslipidemia, peripheral artery disease, lower ejection fraction, and higher EuroSCORE. TLF rate at 3 years was significantly higher in HD group than in non-HD group (adjusted hazard ratio [HR] 2.43 [1.75–3.38], p < 0.001). Cardiac mortality and TLR rate were also significantly higher in HD group than in non-HD group (adjusted HR 3.85 [2.34–6.34], p < 0.001, and HR 2.10 [1.41–3.14], p < 0.001, respectively). Conclusions: HD was strongly associated with adverse cardiac events after PCI for ULMCA distal bifurcation lesions with DES.