Impact of moderate renal insufficiency on restenosis and adverse clinical events after paclitaxel-eluting and bare metal stent implantation: Results from the TAXUS-IV Trial

Halkin, Amir; Mehran, Roxana; Casey, Christopher; Gordon, Paul; Matthews, Ray V.; Wilson, B. Hadley; Leon, Martin B.; Russell, Mary E.; Ellis, Stephen G.; Stone, Gregg W.

doi:10.1016/j.ahj.2005.01.032

Cited by 82 publications

(73 citation statements)

References 17 publications

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“…[49][50][51][52] Moreover, Nakazawa et al 45 reported acute ST complicated with MI in 2 patients with RI. Halkin et al 4,53 demonstrated that ST rates were higher after DES than BMS use, regardless of patients' renal function. Subacute thrombosis was reported in 2 studies.…”

Section: Des Thrombosismentioning

confidence: 99%

“…4 Reintervention in focal restenosis is associated with better outcomes than the outcomes in nonfocal restenotic lesions. From the limited data available, it appears that focal restenosis is more likely to occur than nonfocal restenosis with DES use in patients with RI.…”

Section: Pattern Of Restenosismentioning

confidence: 99%

“…Target lesion revascularization after BMS was similar to that reported by Das et al 61 ; however, TLR after SES use was higher than that reported by Hassani et al 24 and Das et al 61 In the series reported by Ishio et al, 42 the mortality rate was lower than in these 2 studies (2% vs 16% 24 and 25% 61 ). Although the superiority of DES has yet to be established in patients with RI, [3][4][5]57 3 studies 38,53,61 have shown the superiority of SES compared with BMS, and 2 studies 42,60 have shown the superiority of BMS implants. Table 2 shows that DES use is associated with a nonsignificant reduction of restenosis and mortality in dialysis patients.…”

Section: -65mentioning

confidence: 99%

“…13 In the current review, we tallied the outcomes of 12,189 patients with various degrees of chronic RI who underwent DES implantation in 16 studies. [2][3][4][5]24,38,42,45,53,[57][58][59][60][61][62][63] Ten studies compared DES and BMS use [3][4][5]38,42,53,57,60,61,63 ; the DES subtype was specified in 12 studies (SES ). One study reported on all 3 types of stents in chronic RI.…”

Section: Impact Of Chronic Ri On Outcomes After Des Usementioning

confidence: 99%

“…[1][2][3][4][5] In patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI), even mild RI is an independent predictor of worse outcomes. 1 Renal insufficiency is a potent risk factor for CAD and qualifies as a coronary risk equivalent.…”

mentioning

confidence: 99%

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Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

El‐Menyar

Suwaidi

Holmes

2010

Mayo Clinic Proceedings

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Renal insufficiency (RI) has been shown to be associated with increased major adverse cardiovascular events after percutaneous coronary intervention. We reviewed the impact of RI on the pathogenesis of coronary artery disease and outcomes after percutaneous coronary intervention in the form of drug-eluting stent (DES) implantation in these high-risk patients. We searched the English-language literature indexed in MEDLINE, Scopus, and EBS-CO Host research databases from 1990 through January 2009, using as search terms coronary revascularization, drug-eluting stent, and renal insufficiency. Studies that assessed DES implantation in patients with various degrees of RI were selected for review. Most of the available data were extracted from observational studies, and data from randomized trials formed the basis of a post hoc analysis. The outcomes after coronary revascularization were less favorable in patients with RI than in those with normal renal function. In patients with RI, DES implantation yielded better outcomes than did use of bare-metal stents. Randomized trials are needed to define optimal treatment of these high-risk patients with coronary artery disease. © 2010 Mayo Foundation for Medical Education and ResearchR enal insufficiency (RI), defined as creatinine clearance lower than or equal to 60 mL/min, is prevalent in patients with coronary artery disease (CAD). [1][2][3][4][5] In patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI), even mild RI is an independent predictor of worse outcomes.1 Renal insufficiency is a potent risk factor for CAD and qualifies as a coronary risk equivalent. Chronic RI not only increases cardiovascular event risk but also is associated with worse outcomes if an event occurs. 6 Diagnostic coronary angiography and PCI are used less frequently in patients with reduced renal function; risk of complications from these procedures is increased in the presence of RI. 7,8 This increased risk has been shown to occur at even moderate levels of RI, despite the use of advanced stent technology and optimal adjunctive medical therapy. Best et al 10 reported an RI prevalence of 49.1% in patients undergoing elective PCI. In that study, RI had a negative impact similar to that of diabetes mellitus (DM) on cardiovascular outcomes.10 One year after PCI, chronic RI was associated with a doubling of mortality in patients with mild RI, a 5-fold increase in patients with moderate RI, and a 12-fold increase in patients with severe RI. 10 In primary PCI for myocardial infarction (MI), a notable incremental reduction in survival was evident for each decline of 10 mL/min in creatinine clearance.11 Unfortunately, most randomized trials of patients undergoing PCI have excluded patients with severe RI. 12,13 This narrative review aims to identify the impact of a drug-eluting stent (DES) in the performance of PCI in patients with RI. METHODSWe evaluated the impact of RI on the pathogenesis of CAD and outcomes after PCI (in the form of DES implantation) in these high...

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Section: Des Thrombosismentioning

confidence: 99%

Section: Pattern Of Restenosismentioning

confidence: 99%

Section: -65mentioning

confidence: 99%

Section: Impact Of Chronic Ri On Outcomes After Des Usementioning

confidence: 99%

mentioning

confidence: 99%

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Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

El‐Menyar

Suwaidi

Holmes

2010

Mayo Clinic Proceedings

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Impact of renal insufficiency on clinical and angiographic outcomes following percutaneous coronary intervention with sirolimus‐eluting stents

Nakazawa

Tanabe

Aoki

et al. 2007

Cathet Cardio Intervent

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Neointimal growth following SES implantation is more pronounced in patients with renal insufficiency, especially those undergoing dialysis, compared with patients with normal renal function. Regardless of the beneficial effect of SES, the increased risk of MACE mainly due to high incidence of target vessel revascularization in the subgroup of patients with renal insufficiency should be taken into account.

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Impact of renal insufficiency on safety and efficacy of drug‐eluting stents compared to bare‐metal stents at 6 years

Şimşek

Magro

Boersma

et al. 2012

Cathet Cardio Intervent

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Impact of moderate renal insufficiency on restenosis and adverse clinical events after paclitaxel-eluting and bare metal stent implantation: Results from the TAXUS-IV Trial

Cited by 82 publications

References 17 publications

Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

Use of Drug-Eluting Stents in Patients With Coronary Artery Disease and Renal Insufficiency

Impact of renal insufficiency on clinical and angiographic outcomes following percutaneous coronary intervention with sirolimus‐eluting stents

Impact of renal insufficiency on safety and efficacy of drug‐eluting stents compared to bare‐metal stents at 6 years

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