One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry
Abstract Background Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD). Objective The outcome following revascularization using contemporary technologies (new-generation abluminal sirolimus-eluting stents with thin struts) in patients with CKD (...
| Main Authors: | , , , , , , , , , , , , |
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| Other Authors: | |
| Format: | Article |
| Language: | English |
| Published: |
Springer Science and Business Media LLC
2020
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| Online Access: | https://hdl.handle.net/1721.1/126861 |
| _version_ | 1826191688811413504 |
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| author | Scholz, Sean S. Lauder, Lucas Ewen, Sebastian Kulenthiran, Saarraaken Marx, Nikolaus Sakhov, Orazbek Kauer, Floris Witkowski, Adam Vaglimigli, Marco Wijns, William Scheller, Bruno Böhm, Michael Mahfoud, Felix |
| author2 | Massachusetts Institute of Technology. Institute for Medical Engineering & Science |
| author_facet | Massachusetts Institute of Technology. Institute for Medical Engineering & Science Scholz, Sean S. Lauder, Lucas Ewen, Sebastian Kulenthiran, Saarraaken Marx, Nikolaus Sakhov, Orazbek Kauer, Floris Witkowski, Adam Vaglimigli, Marco Wijns, William Scheller, Bruno Böhm, Michael Mahfoud, Felix |
| author_sort | Scholz, Sean S. |
| collection | MIT |
| description | Abstract
Background
Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD).
Objective
The outcome following revascularization using contemporary technologies (new-generation abluminal sirolimus-eluting stents with thin struts) in patients with CKD (i.e., glomerular filtration rate of < 60 mL/min/1.73m2) and in patients with hemodialysis (HD) is unknown.
Methods
e-Ultimaster is a prospective, single-arm, multi-center registry with clinical follow-up at 3 months and 1 year.
Results
A total of 19,475 patients were enrolled, including 1466 patients with CKD, with 167 undergoing HD. Patients with CKD had a higher prevalence of overall comorbidities, multiple/small vessel disease (≤ 2.75 mm), bifurcation lesions, and more often left main artery treatments (all p < 0.0001) when compared with patients with normal renal function (reference). CKD patients had a higher risk of target lesion failure (unadjusted OR, 2.51 [95% CI 2.04–3.08]), target vessel failure (OR, 2.44 [95% CI 2.01–2.96]), patient-oriented composite end point (OR, 2.19 [95% CI 1.87–2.56]), and major adverse cardiovascular events (OR, 2.34 [95% CI 1.93–2.83, p for all < 0.0001]) as reference. The rates of target lesion revascularization (OR, 1.17 [95% CI 0.79–1.73], p = 0.44) were not different. Bleeding complications were more frequently observed in CKD than in the reference (all p < 0.0001).
Conclusion
In this worldwide registry, CKD patients presented with more comorbidities and more complex lesions when compared with the reference population. They experienced higher rate of adverse events at 1-year follow-up.
Graphic abstract
One-year summary outcomes of contemporary PCI in renal insufficiency. CKD chronic kidney disease, POCE patient oriented composite endpoint, MACE major adverse cardiovascular events, TLF target lesion failure, TLR target lesion revascularization, ST stent thrombosis |
| first_indexed | 2024-09-23T08:59:49Z |
| format | Article |
| id | mit-1721.1/126861 |
| institution | Massachusetts Institute of Technology |
| language | English |
| last_indexed | 2024-09-23T08:59:49Z |
| publishDate | 2020 |
| publisher | Springer Science and Business Media LLC |
| record_format | dspace |
| spelling | mit-1721.1/1268612022-09-26T09:43:52Z One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry Scholz, Sean S. Lauder, Lucas Ewen, Sebastian Kulenthiran, Saarraaken Marx, Nikolaus Sakhov, Orazbek Kauer, Floris Witkowski, Adam Vaglimigli, Marco Wijns, William Scheller, Bruno Böhm, Michael Mahfoud, Felix Massachusetts Institute of Technology. Institute for Medical Engineering & Science Abstract Background Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD). Objective The outcome following revascularization using contemporary technologies (new-generation abluminal sirolimus-eluting stents with thin struts) in patients with CKD (i.e., glomerular filtration rate of < 60 mL/min/1.73m2) and in patients with hemodialysis (HD) is unknown. Methods e-Ultimaster is a prospective, single-arm, multi-center registry with clinical follow-up at 3 months and 1 year. Results A total of 19,475 patients were enrolled, including 1466 patients with CKD, with 167 undergoing HD. Patients with CKD had a higher prevalence of overall comorbidities, multiple/small vessel disease (≤ 2.75 mm), bifurcation lesions, and more often left main artery treatments (all p < 0.0001) when compared with patients with normal renal function (reference). CKD patients had a higher risk of target lesion failure (unadjusted OR, 2.51 [95% CI 2.04–3.08]), target vessel failure (OR, 2.44 [95% CI 2.01–2.96]), patient-oriented composite end point (OR, 2.19 [95% CI 1.87–2.56]), and major adverse cardiovascular events (OR, 2.34 [95% CI 1.93–2.83, p for all < 0.0001]) as reference. The rates of target lesion revascularization (OR, 1.17 [95% CI 0.79–1.73], p = 0.44) were not different. Bleeding complications were more frequently observed in CKD than in the reference (all p < 0.0001). Conclusion In this worldwide registry, CKD patients presented with more comorbidities and more complex lesions when compared with the reference population. They experienced higher rate of adverse events at 1-year follow-up. Graphic abstract One-year summary outcomes of contemporary PCI in renal insufficiency. CKD chronic kidney disease, POCE patient oriented composite endpoint, MACE major adverse cardiovascular events, TLF target lesion failure, TLR target lesion revascularization, ST stent thrombosis 2020-08-31T23:51:44Z 2020-08-31T23:51:44Z 2019-12 2019-09 2020-06-26T12:34:34Z Article http://purl.org/eprint/type/JournalArticle 1861-0684 1861-0692 https://hdl.handle.net/1721.1/126861 Scholz, Sean S. et al. "One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry." Clinical Research in Cardiology 109, 7 (December 2019): 845–856 © 2019 Springer Nature en http://dx.doi.org/10.1007/s00392-019-01575-y Clinical Research in Cardiology Creative Commons Attribution https://creativecommons.org/licenses/by/4.0/ The Author(s) application/pdf Springer Science and Business Media LLC Springer Berlin Heidelberg |
| spellingShingle | Scholz, Sean S. Lauder, Lucas Ewen, Sebastian Kulenthiran, Saarraaken Marx, Nikolaus Sakhov, Orazbek Kauer, Floris Witkowski, Adam Vaglimigli, Marco Wijns, William Scheller, Bruno Böhm, Michael Mahfoud, Felix One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry |
| title | One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry |
| title_full | One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry |
| title_fullStr | One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry |
| title_full_unstemmed | One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry |
| title_short | One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry |
| title_sort | one year clinical outcomes in patients with renal insufficiency after contemporary pci data from a multicenter registry |
| url | https://hdl.handle.net/1721.1/126861 |
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