Clinical outcomes following sirolimus-eluting stent implantation in patients with end-stage renal disease: Korean Multicenter Angioplasty Team (KOMATE) Registry

Byoung Keuk Kim, Sungjin Oh, Dong Woon Jeon, Donghoon Choi, Yangsoo Jang, Hyuck Moon Kwon, Jae Hun Jung, Kihwan Kwon, Joo Young Yang

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Abstract

Background and Objectives: Sirolimus-eluting stents (SES), as opposed to bare metal stents (BMS), have been shown to markedly reduce restenosis. However, many clinical trials have excluded the subset of patients (pts) with end-stage renal disease (ESRD). The aim of this study was to evaluate the clinical outcomes following SES implantation in ESRD pts. Subjects and Methods: We analyzed the clinical outcomes in 50 pts from our registry following SES implantation, and compared the outcomes between those with ESRD receiving SES (SES-ESRD) and BMS (BMS-ESRD), and with non-ESRD pts following SES implantation (SES-non ESRD). Results: A comparison of the SES-ESRD (50 pts, 72 lesions) with BMS-ESRD groups (42 pts, 45 lesions); those in the SES-ESRD group included; diabetes 78%, hypertension 94% and age 62 ±10 years. Those in the SES-ESRD group were more likely to have diabetes (diabetes of BMS-ESRD, 57%; p=0.04). The reference vessel diameters (RVD) of the SES-ESRD group were smaller (2.76±0.50 mm vs. 3.05±0.46 mm, p<0.001), but the lesion length was longer (25.6 ±7.0 mm vs. 19.1 ±8.8 mm, p<0.001) than those of the BMS-ESRD group. The SES-ESRD group had a lower 1-year major adverse cardiac events (MACE) rate than the BMS-ESRD group (6.0% vs. 33.3%; p< 0.001). There were no differences in mortality and incidence of myocardial infarction between the two groups. The incidence of target vessel revascularization decreased significantly in the SES-ESRD group (2.0% vs. 19.0%, p=0.01). From a multivariate regression analysis, the use of SES was the only significant independent predictor of MACE (OR=0.054, 95% confidence interval 0.01 to 0.26, p<0.001). A comparison with SES-non ESRD group in our total registry (644 pts, 758 lesions); MACE in the SES-ESRD group (6.0%) was higher than in the SES-non ESRD group (3.1%), but there was no statistical significance (p=0.23). Conclusion: Compared with BMS, SES caused an improvement in the clinical outcomes in pts with ESRD.

Original languageEnglish
Pages (from-to)424-430
Number of pages7
JournalKorean Circulation Journal
Volume36
Issue number6
DOIs
Publication statusPublished - 2006 Jan 1

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Sirolimus
Angioplasty
Chronic Kidney Failure
Stents
Registries
Metals

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Byoung Keuk ; Oh, Sungjin ; Jeon, Dong Woon ; Choi, Donghoon ; Jang, Yangsoo ; Kwon, Hyuck Moon ; Jung, Jae Hun ; Kwon, Kihwan ; Yang, Joo Young. / Clinical outcomes following sirolimus-eluting stent implantation in patients with end-stage renal disease : Korean Multicenter Angioplasty Team (KOMATE) Registry. In: Korean Circulation Journal. 2006 ; Vol. 36, No. 6. pp. 424-430.
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title = "Clinical outcomes following sirolimus-eluting stent implantation in patients with end-stage renal disease: Korean Multicenter Angioplasty Team (KOMATE) Registry",
abstract = "Background and Objectives: Sirolimus-eluting stents (SES), as opposed to bare metal stents (BMS), have been shown to markedly reduce restenosis. However, many clinical trials have excluded the subset of patients (pts) with end-stage renal disease (ESRD). The aim of this study was to evaluate the clinical outcomes following SES implantation in ESRD pts. Subjects and Methods: We analyzed the clinical outcomes in 50 pts from our registry following SES implantation, and compared the outcomes between those with ESRD receiving SES (SES-ESRD) and BMS (BMS-ESRD), and with non-ESRD pts following SES implantation (SES-non ESRD). Results: A comparison of the SES-ESRD (50 pts, 72 lesions) with BMS-ESRD groups (42 pts, 45 lesions); those in the SES-ESRD group included; diabetes 78{\%}, hypertension 94{\%} and age 62 ±10 years. Those in the SES-ESRD group were more likely to have diabetes (diabetes of BMS-ESRD, 57{\%}; p=0.04). The reference vessel diameters (RVD) of the SES-ESRD group were smaller (2.76±0.50 mm vs. 3.05±0.46 mm, p<0.001), but the lesion length was longer (25.6 ±7.0 mm vs. 19.1 ±8.8 mm, p<0.001) than those of the BMS-ESRD group. The SES-ESRD group had a lower 1-year major adverse cardiac events (MACE) rate than the BMS-ESRD group (6.0{\%} vs. 33.3{\%}; p< 0.001). There were no differences in mortality and incidence of myocardial infarction between the two groups. The incidence of target vessel revascularization decreased significantly in the SES-ESRD group (2.0{\%} vs. 19.0{\%}, p=0.01). From a multivariate regression analysis, the use of SES was the only significant independent predictor of MACE (OR=0.054, 95{\%} confidence interval 0.01 to 0.26, p<0.001). A comparison with SES-non ESRD group in our total registry (644 pts, 758 lesions); MACE in the SES-ESRD group (6.0{\%}) was higher than in the SES-non ESRD group (3.1{\%}), but there was no statistical significance (p=0.23). Conclusion: Compared with BMS, SES caused an improvement in the clinical outcomes in pts with ESRD.",
author = "Kim, {Byoung Keuk} and Sungjin Oh and Jeon, {Dong Woon} and Donghoon Choi and Yangsoo Jang and Kwon, {Hyuck Moon} and Jung, {Jae Hun} and Kihwan Kwon and Yang, {Joo Young}",
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journal = "Korean Circulation Journal",
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Clinical outcomes following sirolimus-eluting stent implantation in patients with end-stage renal disease : Korean Multicenter Angioplasty Team (KOMATE) Registry. / Kim, Byoung Keuk; Oh, Sungjin; Jeon, Dong Woon; Choi, Donghoon; Jang, Yangsoo; Kwon, Hyuck Moon; Jung, Jae Hun; Kwon, Kihwan; Yang, Joo Young.

In: Korean Circulation Journal, Vol. 36, No. 6, 01.01.2006, p. 424-430.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcomes following sirolimus-eluting stent implantation in patients with end-stage renal disease

T2 - Korean Multicenter Angioplasty Team (KOMATE) Registry

AU - Kim, Byoung Keuk

AU - Oh, Sungjin

AU - Jeon, Dong Woon

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Kwon, Hyuck Moon

AU - Jung, Jae Hun

AU - Kwon, Kihwan

AU - Yang, Joo Young

PY - 2006/1/1

Y1 - 2006/1/1

N2 - Background and Objectives: Sirolimus-eluting stents (SES), as opposed to bare metal stents (BMS), have been shown to markedly reduce restenosis. However, many clinical trials have excluded the subset of patients (pts) with end-stage renal disease (ESRD). The aim of this study was to evaluate the clinical outcomes following SES implantation in ESRD pts. Subjects and Methods: We analyzed the clinical outcomes in 50 pts from our registry following SES implantation, and compared the outcomes between those with ESRD receiving SES (SES-ESRD) and BMS (BMS-ESRD), and with non-ESRD pts following SES implantation (SES-non ESRD). Results: A comparison of the SES-ESRD (50 pts, 72 lesions) with BMS-ESRD groups (42 pts, 45 lesions); those in the SES-ESRD group included; diabetes 78%, hypertension 94% and age 62 ±10 years. Those in the SES-ESRD group were more likely to have diabetes (diabetes of BMS-ESRD, 57%; p=0.04). The reference vessel diameters (RVD) of the SES-ESRD group were smaller (2.76±0.50 mm vs. 3.05±0.46 mm, p<0.001), but the lesion length was longer (25.6 ±7.0 mm vs. 19.1 ±8.8 mm, p<0.001) than those of the BMS-ESRD group. The SES-ESRD group had a lower 1-year major adverse cardiac events (MACE) rate than the BMS-ESRD group (6.0% vs. 33.3%; p< 0.001). There were no differences in mortality and incidence of myocardial infarction between the two groups. The incidence of target vessel revascularization decreased significantly in the SES-ESRD group (2.0% vs. 19.0%, p=0.01). From a multivariate regression analysis, the use of SES was the only significant independent predictor of MACE (OR=0.054, 95% confidence interval 0.01 to 0.26, p<0.001). A comparison with SES-non ESRD group in our total registry (644 pts, 758 lesions); MACE in the SES-ESRD group (6.0%) was higher than in the SES-non ESRD group (3.1%), but there was no statistical significance (p=0.23). Conclusion: Compared with BMS, SES caused an improvement in the clinical outcomes in pts with ESRD.

AB - Background and Objectives: Sirolimus-eluting stents (SES), as opposed to bare metal stents (BMS), have been shown to markedly reduce restenosis. However, many clinical trials have excluded the subset of patients (pts) with end-stage renal disease (ESRD). The aim of this study was to evaluate the clinical outcomes following SES implantation in ESRD pts. Subjects and Methods: We analyzed the clinical outcomes in 50 pts from our registry following SES implantation, and compared the outcomes between those with ESRD receiving SES (SES-ESRD) and BMS (BMS-ESRD), and with non-ESRD pts following SES implantation (SES-non ESRD). Results: A comparison of the SES-ESRD (50 pts, 72 lesions) with BMS-ESRD groups (42 pts, 45 lesions); those in the SES-ESRD group included; diabetes 78%, hypertension 94% and age 62 ±10 years. Those in the SES-ESRD group were more likely to have diabetes (diabetes of BMS-ESRD, 57%; p=0.04). The reference vessel diameters (RVD) of the SES-ESRD group were smaller (2.76±0.50 mm vs. 3.05±0.46 mm, p<0.001), but the lesion length was longer (25.6 ±7.0 mm vs. 19.1 ±8.8 mm, p<0.001) than those of the BMS-ESRD group. The SES-ESRD group had a lower 1-year major adverse cardiac events (MACE) rate than the BMS-ESRD group (6.0% vs. 33.3%; p< 0.001). There were no differences in mortality and incidence of myocardial infarction between the two groups. The incidence of target vessel revascularization decreased significantly in the SES-ESRD group (2.0% vs. 19.0%, p=0.01). From a multivariate regression analysis, the use of SES was the only significant independent predictor of MACE (OR=0.054, 95% confidence interval 0.01 to 0.26, p<0.001). A comparison with SES-non ESRD group in our total registry (644 pts, 758 lesions); MACE in the SES-ESRD group (6.0%) was higher than in the SES-non ESRD group (3.1%), but there was no statistical significance (p=0.23). Conclusion: Compared with BMS, SES caused an improvement in the clinical outcomes in pts with ESRD.

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