OBJECTIVES: The goal of this study was to determine if restenosis is increased in mild and moderate chronic kidney disease (CKD) patients after percutaneous coronary intervention (PCI). BACKGROUND:Mortality is increased in CKD after PCI. Restenosis may contribute to increased late mortality. METHODS: We analyzed 11,187 patients with a creatinine <1.8 mg/dl from the Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) trial, grouped by estimated creatinine clearance (CrCl) (<60, 60 to 89, >89 ml/min). The Cox proportional hazards models investigated the association between CrCl group and death, myocardial infarction, and target vessel revascularization (TVR). Generalized estimating equation regression models determined the association between CrCl group and lesion-specific restenosis. RESULTS: At 30 days, there was no difference in myocardial infarction, death, or TVR between the CrCl groups. At nine months, mortality was higher in the lowest CrCl group (2.2%, 1.2%, 0.8%; p < 0.001), which was no longer significant after adjusting for confounding variables. Myocardial infarction and TVR were not different between the groups. In patients undergoing protocol follow-up angiography, restenosis (>/=50%) was not increased with CKD (32%, 32%, 37%; p = 0.02). CONCLUSIONS:Mortality nine months after PCI is mildly increased in mild or moderate CKD patients. However, restenosis is not and does not account for the increased mortality.
RCT Entities:
OBJECTIVES: The goal of this study was to determine if restenosis is increased in mild and moderate chronic kidney disease (CKD) patients after percutaneous coronary intervention (PCI). BACKGROUND: Mortality is increased in CKD after PCI. Restenosis may contribute to increased late mortality. METHODS: We analyzed 11,187 patients with a creatinine <1.8 mg/dl from the Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) trial, grouped by estimated creatinine clearance (CrCl) (<60, 60 to 89, >89 ml/min). The Cox proportional hazards models investigated the association between CrCl group and death, myocardial infarction, and target vessel revascularization (TVR). Generalized estimating equation regression models determined the association between CrCl group and lesion-specific restenosis. RESULTS: At 30 days, there was no difference in myocardial infarction, death, or TVR between the CrCl groups. At nine months, mortality was higher in the lowest CrCl group (2.2%, 1.2%, 0.8%; p < 0.001), which was no longer significant after adjusting for confounding variables. Myocardial infarction and TVR were not different between the groups. In patients undergoing protocol follow-up angiography, restenosis (>/=50%) was not increased with CKD (32%, 32%, 37%; p = 0.02). CONCLUSIONS: Mortality nine months after PCI is mildly increased in mild or moderate CKDpatients. However, restenosis is not and does not account for the increased mortality.
Authors: Tadeusz Osadnik; Jarosław Wasilewski; Andrzej Lekston; Joanna Strzelczyk; Anna Kurek; Aleksander Rafał Gutowski; Krzysztof Dyrbuś; Kamil Bujak; Rafał Reguła; Piotr Rozentryt; Bożena Szyguła-Jurkiewicz; Lech Poloński Journal: Clin Res Cardiol Date: 2014-03-09 Impact factor: 5.460
Authors: David M Charytan; Lars Wallentin; Bo Lagerqvist; Rudolf Spacek; Robbert J De Winter; Noam M Stern; Eugene Braunwald; Christopher P Cannon; Niteesh K Choudhry Journal: Clin J Am Soc Nephrol Date: 2009-05-07 Impact factor: 8.237
Authors: Khurshid Ahmed; Myung Ho Jeong; Rabin Chakraborty; Sumera Ahmed; Young Joon Hong; Doo Sun Sim; Keun Ho Park; Ju Han Kim; Youngkeun Ahn; Jung Chaee Kang; Myeong Chan Cho; Chong Jin Kim; Young Jo Kim Journal: Korean Circ J Date: 2012-12-31 Impact factor: 3.243