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Comparison between biodegradable- and durable-polymer everolimus-eluting stents in hemodialysis patients with coronary artery disease

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Abstract

To investigate the clinical outcomes after biodegradable-polymer (BP) and durable-polymer (DP) everolimus-eluting stent (EES) implantation in hemodialysis (HD) patients with coronary artery disease. We enrolled 221 consecutive HD patients successfully treated with EES implantation for coronary lesions. Over the following 2 years, we assessed the incidence of target lesion revascularization (TLR) and major adverse cardiac event (MACE), defined as the composite endpoint of TLR, all-cause mortality, or myocardial infarction. We performed a propensity-score matching analysis and collected follow-up coronary angiography data. There were 91 patients in the BP-EES group and 130 in the DP-EES group. Male sex and diabetes rates were significantly lower in the BP-EES group than in the DP-EES group. A debulking device was less frequently used in the BP-EES group than in the DP-EES group (7.6% vs. 21.5%, p = 0.006). TLR occurred in 38 patients, while stent thrombosis was observed in 3 patients; 19 patients died. TLR and MACE rates at 2 years were comparable between the two groups (19.2% in the BP-EES group vs. 20.4% in the DP-EES group, p = 0.73 and 26.9% vs. 34.2%, p = 0.93, respectively). In the propensity-score-matched cohort, TLR and MACE rates were similar between the two groups (19.2% in the BP-EES group vs. 18.1% in the DP-EES group, p = 0.69, and 26.9% vs. 30.2%, p = 0.66, respectively). Restenosis rates at follow-up angiography were similar between the two groups (p = 0.79). In hemodialysis patients, BP-EES and DP-EES showed similar 2-year clinical outcomes.

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Authors and Affiliations

  1. Department of Cardiology, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya, Aichi, 454-0933, Japan

    Ryuta Ito, Satoru Oshima, Takashi Sakakibara & Motohiko Kakuno

  2. Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine, Maebashi, Japan

    Hideki Ishii

  3. Department of Cardiovascular Surgery, Nagoya Kyoritsu Hospital, Nagoya, Japan

    Takuya Nakayama

  4. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Toyoaki Murohara

Authors
  1. Ryuta Ito
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  2. Hideki Ishii
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  3. Satoru Oshima
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  4. Takuya Nakayama
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  5. Takashi Sakakibara
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  6. Motohiko Kakuno
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  7. Toyoaki Murohara
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Contributions

Conceptualization: RI and TS; methodology: SO and TN; formal analysis and investigation: RI and MK; writing—original draft preparation: RI; writing—review and editing: HI; supervision: TM.

Corresponding author

Correspondence to Ryuta Ito.

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Conflict of interest

H.I. received lecture fees from Astellas Pharma Inc. Daiichi-Sankyo Pharma Inc. and MSD K.K. T.M. received lecture fees from Bayel Pharmaceutical Co., Ltd., Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K.K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Pfizer Japan Inc., Sanofi-aventis K.K., and Takeda Pharmaceutical Co., Ltd. T.M. received unrestricted research grant for Department of Cardiology, Nagoya University Graduate School of Medicine from Astellas Pharma Inc, Daiichi Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K.K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K.K., Otsuka Pharma Ltd., Pfizer Japan Inc., Sanofi-aventis K.K., Takeda Pharmaceutical Co., Ltd., Tei** Pharma Ltd.

Ethical approval

This retrospective study was approved by the institutional review board of Nagoya Kyoritsu Hospital and was conducted in accordance with the Helsinki Declaration.

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Ito, R., Ishii, H., Oshima, S. et al. Comparison between biodegradable- and durable-polymer everolimus-eluting stents in hemodialysis patients with coronary artery disease. Cardiovasc Interv and Ther 37, 475–482 (2022). https://doi.org/10.1007/s12928-021-00827-x

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  • DOI: https://doi.org/10.1007/s12928-021-00827-x

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