Key result
In dialysis patients undergoing percutaneous coronary intervention, sirolimus-eluting stents significantly reduced the 1-year risk of major adverse cardiac events compared to bare-metal stents (RR 0.70).
Why the study?
Does sirolimus-eluting stent implantation reduce major adverse cardiac events in dialysis patients undergoing percutaneous coronary intervention compared to bare-metal stents?
Observational (n=204)
No
Does sirolimus-eluting stent implantation reduce major adverse cardiac events in dialysis patients undergoing percutaneous coronary intervention compared to bare-metal stents?
Relative Risk: 0.7 (95% CI 0.52–0.93)
Absolute Event Rate: 25.2% vs 38.2%
p-value: p=0.015
In dialysis patients undergoing PCI, sirolimus-eluting stents moderately reduced 1-year MACE compared to bare-metal stents, though target lesion revascularization rates remained relatively high.
May support sirolimus-eluting stents in dialysis PCI; hypothesis-generating and requires randomized confirmation.
BACKGROUND: The efficacy of sirolimus-eluting stents (SESs) has not been established in dialysis patients. METHODS AND RESULTS: This study was a non-randomized observational single-center registry in a community hospital: data for 80 consecutive dialysis patients who underwent percutaneous coronary intervention (PCI) with SES were compared with those of a historical group of consecutive 124 dialysis patients treated with bare-metal stents (BMS). After 1 year, the cumulative incidence of major adverse cardiac events (MACE), comprising cardiac death, nonfatal myocardial infarction, stent thrombosis, or target lesion revascularization (TLR), was 25.2% in the SES group and 38.2% in the BMS group (p=0.048). In multivariate analysis, use of SES remained an independent predictor of MACE at 1 year after PCI (risk ratio 0.70, 95% confidence interval 0.52-0.93, p=0.015). Rates of TLR were 21.7% in the SES group and 30.9% in the BMS group and (p=0.15). Subgroup analysis showed that use of SES was effective in patients with small vessels, non-diabetic patients, and patients without highly calcified lesions. CONCLUSIONS: In dialysis patients, the implantation of SES was moderately effective in reducing MACE at 1 year after PCI as compared with BMS. However, the TLR rate at 1 year was relatively higher than previously reported.
No takes yet. Share an insight, caveat, or question.
Okada et al. (2008) conducted an observational in Coronary artery disease in dialysis patients (n=204). Sirolimus-eluting stent (SES) vs. Bare-metal stent (BMS) was evaluated on Major adverse cardiac events (MACE), defined as cardiac death, nonfatal myocardial infarction, stent thrombosis, or target lesion revascularization (RR 0.70, 95% CI 0.52-0.93, p=0.015). In dialysis patients undergoing percutaneous coronary intervention, sirolimus-eluting stents significantly reduced the 1-year risk of major adverse cardiac events compared to bare-metal stents (RR 0.70).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: