Ito Ryuta, Ishii Hideki, Oshima Satoru, Nakayama Takuya, Sakakibara Takashi, Kakuno Motohiko, Murohara Toyoaki
Department of Cardiology, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya, Aichi, 454-0933, Japan.
Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan.
Cardiovasc Interv Ther. 2022 Jul;37(3):475-482. doi: 10.1007/s12928-021-00827-x. Epub 2021 Nov 24.
To investigate the clinical outcomes after biodegradable-polymer (BP) and durable-polymer (DP) everolimus-eluting stent (EES) implantation in hemodialysis (HD) patients with coronary artery disease. We enrolled 221 consecutive HD patients successfully treated with EES implantation for coronary lesions. Over the following 2 years, we assessed the incidence of target lesion revascularization (TLR) and major adverse cardiac event (MACE), defined as the composite endpoint of TLR, all-cause mortality, or myocardial infarction. We performed a propensity-score matching analysis and collected follow-up coronary angiography data. There were 91 patients in the BP-EES group and 130 in the DP-EES group. Male sex and diabetes rates were significantly lower in the BP-EES group than in the DP-EES group. A debulking device was less frequently used in the BP-EES group than in the DP-EES group (7.6% vs. 21.5%, p = 0.006). TLR occurred in 38 patients, while stent thrombosis was observed in 3 patients; 19 patients died. TLR and MACE rates at 2 years were comparable between the two groups (19.2% in the BP-EES group vs. 20.4% in the DP-EES group, p = 0.73 and 26.9% vs. 34.2%, p = 0.93, respectively). In the propensity-score-matched cohort, TLR and MACE rates were similar between the two groups (19.2% in the BP-EES group vs. 18.1% in the DP-EES group, p = 0.69, and 26.9% vs. 30.2%, p = 0.66, respectively). Restenosis rates at follow-up angiography were similar between the two groups (p = 0.79). In hemodialysis patients, BP-EES and DP-EES showed similar 2-year clinical outcomes.
为研究生物可降解聚合物（BP）和耐用聚合物（DP）依维莫司洗脱支架（EES）植入术在冠心病血液透析（HD）患者中的临床结局。我们纳入了221例因冠状动脉病变成功接受EES植入术的连续性HD患者。在接下来的2年里，我们评估了靶病变血运重建（TLR）和主要不良心脏事件（MACE）的发生率，MACE定义为TLR、全因死亡率或心肌梗死的复合终点。我们进行了倾向评分匹配分析并收集了随访冠状动脉造影数据。BP-EES组有91例患者，DP-EES组有130例患者。BP-EES组的男性比例和糖尿病发生率显著低于DP-EES组。BP-EES组使用减容装置的频率低于DP-EES组（7.6%对21.5%，p = 0.006）。38例患者发生TLR，3例患者观察到支架血栓形成；19例患者死亡。两组2年时的TLR和MACE发生率相当（BP-EES组为19.2%，DP-EES组为20.4%，p = 0.73；分别为26.9%对34.2%，p = 0.93）。在倾向评分匹配队列中，两组的TLR和MACE发生率相似（BP-EES组为19.2%，DP-EES组为18.1%，p = 0.69；分别为26.9%对30.2%，p = 0.66）。随访血管造影时两组的再狭窄率相似（p = 0.79）。在血液透析患者中，BP-EES和DP-EES显示出相似的2年临床结局。
