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Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry).

Publication ,  Journal Article
Green, SM; Selzer, F; Mulukutla, SR; Tadajweski, EJ; Green, JA; Wilensky, RL; Laskey, WK; Cohen, HA; Rao, SV; Weisbord, SD; Lee, JS; Reis, SE ...
Published in: Am J Cardiol
December 1, 2011

Patients with chronic kidney disease (CKD) have a disproportionate burden of coronary artery disease and commonly undergo revascularization. The role and safety of percutaneous coronary intervention (PCI) using drug-eluting stents (DESs) verses bare-metal stents in patients with CKD not on renal replacement therapy has not been fully evaluated. This study investigated the efficacy and safety of DES in patients with CKD not on renal replacement therapy. Patients were drawn from the National Heart, Lung, and Blood Institute Dynamic Registry and were stratified by renal function based on estimated glomerular filtration rate (GFR). Of the 4,157 participants, 1,108 had CKD ("low GFR" <60 ml/min/1.73 m(2)), whereas 3,049 patients had normal renal function ("normal GFR" ≥60 ml/min/1.73 m(2)). For each stratum of renal function we compared risk of death, myocardial infarction, or repeat revascularization between subjects who received DESs and bare-metal stents at the index procedure. Patients with low GFR had higher 1-year rates of death and myocardial infarction and a decreased rate of repeat revascularization compared to patients with normal GFR. Use of DESs was associated with a decreased need for repeat revascularization in the normal-GFR group (adjusted hazard ratio 0.63, 95% confidence interval 0.50 to 0.79, p <0.001) but not in the low-GFR group (hazard ratio 0.69, 95% confidence interval 0.45 to 1.06, p = 0.09). Risks of death and myocardial infarction were not different between the 2 stents in either patient population. In conclusion, presence of CKD predicted poor outcomes after PCI with high rates of mortality regardless of stent type. The effect of DES in decreasing repeat revascularization appeared to be attenuated in these patients.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

December 1, 2011

Volume

108

Issue

11

Start / End Page

1658 / 1664

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Registries
  • Prosthesis Design
  • Prognosis
  • Myocardial Revascularization
  • Middle Aged
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Green, S. M., Selzer, F., Mulukutla, S. R., Tadajweski, E. J., Green, J. A., Wilensky, R. L., … Marroquin, O. C. (2011). Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry). Am J Cardiol, 108(11), 1658–1664. https://doi.org/10.1016/j.amjcard.2011.07.029
Green, Sandy M., Faith Selzer, Suresh R. Mulukutla, Edward J. Tadajweski, Jamie A. Green, Robert L. Wilensky, Warren K. Laskey, et al. “Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry).Am J Cardiol 108, no. 11 (December 1, 2011): 1658–64. https://doi.org/10.1016/j.amjcard.2011.07.029.
Green SM, Selzer F, Mulukutla SR, Tadajweski EJ, Green JA, Wilensky RL, et al. Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry). Am J Cardiol. 2011 Dec 1;108(11):1658–64.
Green, Sandy M., et al. “Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry).Am J Cardiol, vol. 108, no. 11, Dec. 2011, pp. 1658–64. Pubmed, doi:10.1016/j.amjcard.2011.07.029.
Green SM, Selzer F, Mulukutla SR, Tadajweski EJ, Green JA, Wilensky RL, Laskey WK, Cohen HA, Rao SV, Weisbord SD, Lee JS, Reis SE, Kip KE, Kelsey SF, Williams DO, Marroquin OC. Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI Dynamic Registry). Am J Cardiol. 2011 Dec 1;108(11):1658–1664.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

December 1, 2011

Volume

108

Issue

11

Start / End Page

1658 / 1664

Location

United States

Related Subject Headings

  • United States
  • Time Factors
  • Survival Rate
  • Retrospective Studies
  • Registries
  • Prosthesis Design
  • Prognosis
  • Myocardial Revascularization
  • Middle Aged
  • Male