Impact of chronic kidney disease on long-term outcomes for coronary in-stent restenosis after drug-coated balloon angioplasty
| Autor: | Chiu-Yi Hsu, Yu-Wen Cheng, Yi-Hsin Chan, Jian-Rong Peng, Hsin-Fu Lee, Chia-Hung Yang, Pao-Hsien Chu |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Renal function Coronary Artery Disease urologic and male genital diseases Revascularization Cohort Studies Coronary Restenosis Percutaneous Coronary Intervention Risk Factors Internal medicine Angioplasty medicine Humans Renal Insufficiency Chronic Adverse effect business.industry Hazard ratio Percutaneous coronary intervention Drug-Eluting Stents medicine.disease female genital diseases and pregnancy complications Treatment Outcome Pharmaceutical Preparations Cardiology Cardiology and Cardiovascular Medicine business Angioplasty Balloon Kidney disease Cohort study |
| Zdroj: | Journal of cardiology. 78(6) |
| ISSN: | 1876-4738 |
| Popis: | Patients with chronic kidney disease (CKD) and coronary instent restenosis (ISR) treated with drug-coated balloon (DCB) angioplasty have been excluded from randomized controlled trials. We aimed to investigate the clinical impact of CKD stratified by severity, on clinical outcomes for patients with ISR treated with DCB angioplasty.This cohort study enrolled 1,376 patients treated with DCB angioplasty; 639 CKD patients defined as having an estimated glomerular filtration rate (eGFR)60 mL/min/1.73 m2 and 737 patients with preserved renal function were identified. Risks of target vessel failure (TVF), all-cause mortality, and any repeated revascularization were analyzed.The CKD group had a significantly higher risk of TVF [adjusted hazard ratio (HR): 1.337; 95% confidence interval (CI): 1.125-1.590; p = 0.0010], all-cause mortality (adjusted HR: 2.553; 95% CI: 1.494-4.361; p = 0.0006), and any repeated revascularization (adjusted HR: 1.447; 95% CI: 1.087-1.927; p = 0.0114) compared with the non-CKD group. After multivariable adjustment, patients with severe CKD (eGFR = 15-29 mL/min/1.73 m2) and end-stage renal disease (ESRD) (eGFR15 mL/min/1.73 m2) had a significantly higher risk of adverse events comparable to that in patients with preserved renal function.In this cohort study, patients with CKD and ISR undergoing DCB angioplasty had a significantly higher risk of adverse events compared with patients with preserved renal function, whereas subgroups with mild to moderate CKD did not display this difference. Different revascularization strategies may be considered for patients with severe CKD or ESRD with ISR. |
| Databáze: | OpenAIRE |
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