Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease
Background: The presence of calcified lesions in chronic kidney disease (CKD) patients adversely affects the outcomes of percutaneous coronary interventions (PCIs). Lesion modification using rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation may, therefore, be a suitable s...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Journal of Indian College of Cardiology |
| Subjects: | |
| Online Access: | http://www.joicc.org/article.asp?issn=1561-8811;year=2021;volume=11;issue=3;spage=109;epage=115;aulast=Malik |
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| author | Fazila-Tun-Nesa Malik Md Kalimuddin, Nazir Ahmed Mohammad Badiuzzaman Abdul Kayum Khan Ashok Dutta Tawfiq Shahriar Huq Dhiman Banik Mir Nesaruddin Ahmed Md Habibur Rahman Md Abu Tareq Iqbal |
| author_facet | Fazila-Tun-Nesa Malik Md Kalimuddin, Nazir Ahmed Mohammad Badiuzzaman Abdul Kayum Khan Ashok Dutta Tawfiq Shahriar Huq Dhiman Banik Mir Nesaruddin Ahmed Md Habibur Rahman Md Abu Tareq Iqbal |
| author_sort | Fazila-Tun-Nesa Malik |
| collection | DOAJ |
| description | Background: The presence of calcified lesions in chronic kidney disease (CKD) patients adversely affects the outcomes of percutaneous coronary interventions (PCIs). Lesion modification using rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation may, therefore, be a suitable strategy to treat heavily calcified coronary lesions in CKD patients. Aim: The aim of the study was to compare the effectiveness and safety of PCI using RA and new-generation DES for treating calcified coronary lesions in patients with mild versus moderate-to-severe CKD. Methods: This was a single-center, retrospective study. Data were collected from the medical records of all CKD patients with calcified coronary artery lesions who underwent RA + DES implantation from November 2014 to October 2019. The primary outcomes were the rates of in-stent restenosis (ISR), repeat revascularization (RR), and major adverse cardiovascular and cerebrovascular events. Secondary outcomes included procedural success, death after intervention, and procedural/in-hospital complications. Results: A total of 77 and 126 patients with mild and moderate-to-severe CKD were treated with RA + DES. Patients with moderate-to-severe CKD were significantly older when compared to patients with mild CKD (mean age: 66.6 ± 8.2 vs. 59.5 ± 7.7 years, respectively, P < 0.0001). Body mass index was significantly lower in moderate-to-severe CKD group compared to the mild CKD group. The number of patients in whom postdilatation was performed after stent implantation was significantly higher in the moderate-to-severe CKD group compared to the mild CKD group (100% vs. 96%, P = 0.025). Overall procedural success was 97.5% with minimal periprocedural complications. The rates of ISR and RR were not significantly different between patients with mild and moderate-to-severe CKD. The two groups did not differ significantly in terms of procedural success, postprocedural complications, and procedural mortality. Conclusion: RA followed by DES implantation is an effective and safe strategy to treat calcified coronary artery lesions in patients with CKD, regardless of the degree of renal dysfunction. |
| first_indexed | 2024-03-08T05:00:48Z |
| format | Article |
| id | doaj.art-c750f4a54dc44f50807412daee2ab202 |
| institution | Directory Open Access Journal |
| issn | 1561-8811 2213-3615 |
| language | English |
| last_indexed | 2024-03-08T05:00:48Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Indian College of Cardiology |
| spelling | doaj.art-c750f4a54dc44f50807412daee2ab2022024-02-07T12:56:13ZengWolters Kluwer Medknow PublicationsJournal of Indian College of Cardiology1561-88112213-36152021-01-0111310911510.4103/JICC.JICC_68_20Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery diseaseFazila-Tun-Nesa MalikMd Kalimuddin,Nazir AhmedMohammad BadiuzzamanAbdul Kayum KhanAshok DuttaTawfiq Shahriar HuqDhiman BanikMir Nesaruddin AhmedMd Habibur RahmanMd Abu Tareq IqbalBackground: The presence of calcified lesions in chronic kidney disease (CKD) patients adversely affects the outcomes of percutaneous coronary interventions (PCIs). Lesion modification using rotational atherectomy (RA) followed by drug-eluting stent (DES) implantation may, therefore, be a suitable strategy to treat heavily calcified coronary lesions in CKD patients. Aim: The aim of the study was to compare the effectiveness and safety of PCI using RA and new-generation DES for treating calcified coronary lesions in patients with mild versus moderate-to-severe CKD. Methods: This was a single-center, retrospective study. Data were collected from the medical records of all CKD patients with calcified coronary artery lesions who underwent RA + DES implantation from November 2014 to October 2019. The primary outcomes were the rates of in-stent restenosis (ISR), repeat revascularization (RR), and major adverse cardiovascular and cerebrovascular events. Secondary outcomes included procedural success, death after intervention, and procedural/in-hospital complications. Results: A total of 77 and 126 patients with mild and moderate-to-severe CKD were treated with RA + DES. Patients with moderate-to-severe CKD were significantly older when compared to patients with mild CKD (mean age: 66.6 ± 8.2 vs. 59.5 ± 7.7 years, respectively, P < 0.0001). Body mass index was significantly lower in moderate-to-severe CKD group compared to the mild CKD group. The number of patients in whom postdilatation was performed after stent implantation was significantly higher in the moderate-to-severe CKD group compared to the mild CKD group (100% vs. 96%, P = 0.025). Overall procedural success was 97.5% with minimal periprocedural complications. The rates of ISR and RR were not significantly different between patients with mild and moderate-to-severe CKD. The two groups did not differ significantly in terms of procedural success, postprocedural complications, and procedural mortality. Conclusion: RA followed by DES implantation is an effective and safe strategy to treat calcified coronary artery lesions in patients with CKD, regardless of the degree of renal dysfunction.http://www.joicc.org/article.asp?issn=1561-8811;year=2021;volume=11;issue=3;spage=109;epage=115;aulast=Malikchronic kidney diseasedrug-eluting stentsin-sent restenosisrevascularizationrotational atherectomy |
| spellingShingle | Fazila-Tun-Nesa Malik Md Kalimuddin, Nazir Ahmed Mohammad Badiuzzaman Abdul Kayum Khan Ashok Dutta Tawfiq Shahriar Huq Dhiman Banik Mir Nesaruddin Ahmed Md Habibur Rahman Md Abu Tareq Iqbal Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease Journal of Indian College of Cardiology chronic kidney disease drug-eluting stents in-sent restenosis revascularization rotational atherectomy |
| title | Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease |
| title_full | Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease |
| title_fullStr | Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease |
| title_full_unstemmed | Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease |
| title_short | Percutaneous coronary intervention using rotational atherectomy and new-generation drug-eluting stents in mild versus moderate-to-severe chronic kidney disease patients with coronary artery disease |
| title_sort | percutaneous coronary intervention using rotational atherectomy and new generation drug eluting stents in mild versus moderate to severe chronic kidney disease patients with coronary artery disease |
| topic | chronic kidney disease drug-eluting stents in-sent restenosis revascularization rotational atherectomy |
| url | http://www.joicc.org/article.asp?issn=1561-8811;year=2021;volume=11;issue=3;spage=109;epage=115;aulast=Malik |
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