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Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study

OBJECTIVE: To investigate the efficacy and long-term clinical benefits of DES for dialysis patients. BACKGROUND: It is unclear whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation is associated with lower rates of major adverse cardiovascular events (MACE) or m...

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Autores principales: Lee, Hsin-Fu, Wu, Lung-Sheng, Chan, Yi-Hsin, Lee, Cheng-Hung, Liu, Jia-Rou, Tu, Hui-Tzu, Wen, Ming-Shien, Kuo, Chi-Tai, Chen, Wei-Jan, Yeh, Yung-Hsin, See, Lai-Chu, Chang, Shang-Hung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711720/
https://www.ncbi.nlm.nih.gov/pubmed/26731408
http://dx.doi.org/10.1371/journal.pone.0146343
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author Lee, Hsin-Fu
Wu, Lung-Sheng
Chan, Yi-Hsin
Lee, Cheng-Hung
Liu, Jia-Rou
Tu, Hui-Tzu
Wen, Ming-Shien
Kuo, Chi-Tai
Chen, Wei-Jan
Yeh, Yung-Hsin
See, Lai-Chu
Chang, Shang-Hung
author_facet Lee, Hsin-Fu
Wu, Lung-Sheng
Chan, Yi-Hsin
Lee, Cheng-Hung
Liu, Jia-Rou
Tu, Hui-Tzu
Wen, Ming-Shien
Kuo, Chi-Tai
Chen, Wei-Jan
Yeh, Yung-Hsin
See, Lai-Chu
Chang, Shang-Hung
author_sort Lee, Hsin-Fu
collection PubMed
description OBJECTIVE: To investigate the efficacy and long-term clinical benefits of DES for dialysis patients. BACKGROUND: It is unclear whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation is associated with lower rates of major adverse cardiovascular events (MACE) or mortality compared to bare-metal stents (BMS). METHODS: From a nationwide cohort selected from Taiwan’s National Health Insurance Research Database, we enrolled 2,835 dialysis patients who were hospitalized for PCI treatment with stent implantation from Dec 1, 2006. Follow-up was from the date of index hospitalization for PCI until the first MACE, date of death, or December 31, 2011, whichever came first. RESULTS: A total of 738 patients (26.0%) had DES implanted, and 2,097 (74%) had BMS implanted. The medium time to the first MACE was 0.53 years (interquartile range: 0.89 years; range: 0–4.62 years). At 1-year follow-up, patients treated with BMS had significantly, non-fatal myocardial infarction (MI), all-cause mortality, and composite MACE compared to those treated with DES. The overall repeat revascularization with coronary artery bypass graft (CABG), non-fatal MI, all-cause mortality, and composite MACE were significantly lower in patients treated with DES than those treated with BMS. Multivariate cox regression analysis showed that older age, history of diabetes, history of heart failure, history of stroke, and DES vs. BMS were independent significant predictors of MACE. CONCLUSIONS: DES implantation conferred survival benefits in dialysis patients compared with BMS implantation.
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spelling pubmed-47117202016-01-26 Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study Lee, Hsin-Fu Wu, Lung-Sheng Chan, Yi-Hsin Lee, Cheng-Hung Liu, Jia-Rou Tu, Hui-Tzu Wen, Ming-Shien Kuo, Chi-Tai Chen, Wei-Jan Yeh, Yung-Hsin See, Lai-Chu Chang, Shang-Hung PLoS One Research Article OBJECTIVE: To investigate the efficacy and long-term clinical benefits of DES for dialysis patients. BACKGROUND: It is unclear whether percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation is associated with lower rates of major adverse cardiovascular events (MACE) or mortality compared to bare-metal stents (BMS). METHODS: From a nationwide cohort selected from Taiwan’s National Health Insurance Research Database, we enrolled 2,835 dialysis patients who were hospitalized for PCI treatment with stent implantation from Dec 1, 2006. Follow-up was from the date of index hospitalization for PCI until the first MACE, date of death, or December 31, 2011, whichever came first. RESULTS: A total of 738 patients (26.0%) had DES implanted, and 2,097 (74%) had BMS implanted. The medium time to the first MACE was 0.53 years (interquartile range: 0.89 years; range: 0–4.62 years). At 1-year follow-up, patients treated with BMS had significantly, non-fatal myocardial infarction (MI), all-cause mortality, and composite MACE compared to those treated with DES. The overall repeat revascularization with coronary artery bypass graft (CABG), non-fatal MI, all-cause mortality, and composite MACE were significantly lower in patients treated with DES than those treated with BMS. Multivariate cox regression analysis showed that older age, history of diabetes, history of heart failure, history of stroke, and DES vs. BMS were independent significant predictors of MACE. CONCLUSIONS: DES implantation conferred survival benefits in dialysis patients compared with BMS implantation. Public Library of Science 2016-01-05 /pmc/articles/PMC4711720/ /pubmed/26731408 http://dx.doi.org/10.1371/journal.pone.0146343 Text en © 2016 Lee et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Lee, Hsin-Fu
Wu, Lung-Sheng
Chan, Yi-Hsin
Lee, Cheng-Hung
Liu, Jia-Rou
Tu, Hui-Tzu
Wen, Ming-Shien
Kuo, Chi-Tai
Chen, Wei-Jan
Yeh, Yung-Hsin
See, Lai-Chu
Chang, Shang-Hung
Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study
title Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study
title_full Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study
title_fullStr Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study
title_full_unstemmed Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study
title_short Dialysis Patients with Implanted Drug-Eluting Stents Have Lower Major Cardiac Events and Mortality than Those with Implanted Bare-Metal Stents: A Taiwanese Nationwide Cohort Study
title_sort dialysis patients with implanted drug-eluting stents have lower major cardiac events and mortality than those with implanted bare-metal stents: a taiwanese nationwide cohort study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4711720/
https://www.ncbi.nlm.nih.gov/pubmed/26731408
http://dx.doi.org/10.1371/journal.pone.0146343
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