Cardiovascular outcomes following percutaneous coronary intervention with drug-eluting balloons in chronic kidney diseas
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RESEARCH ARTICLE
Open Access
Cardiovascular outcomes following percutaneous coronary intervention with drug-eluting balloons in chronic kidney disease: a retrospective analysis Michael Jonas1†, Maayan Kagan2†, Gal Sella1, Dan Haberman1 and Gil Chernin2*
Abstract Background: Chronic kidney disease (CKD) is associated with poorer outcomes following percutaneous coronary intervention (PCI) with drug-eluting stents. Drug-eluting balloons are used for in-stent restenosis and selected cases of de-novo coronary lesions. Little is known regarding the outcomes of individuals with CKD who undergo PCI with drug-eluting balloons. The goal of this study was to assess outcomes of PCI with drug-eluting balloons in individuals with CKD. Methods: In a retrospective analysis, outcomes of PCI with drug-eluting balloons were compared between 101 patients with CKD and 261 without CKD. CKD was defined as estimated glomerular filtration rate < 60 ml/min/ 1.73m2. We compared demographics, procedure data and clinical outcomes in the first and second years following the procedure. Results: Rates of major adverse cardiac events (MACE) and myocardial infarction were higher in patients with than without CKD: 23.8% vs. 13.8%, P < 0.005 and 15.9% vs. 3.8%, P < 0.001, respectively. Rates of target lesion revascularization were similar, 14.9 and 11.5%, respectively, P = 0.4. Shorter duration of dual anti-platelet therapy was observed among patients with than without CKD (10.0 + 3.4 vs. 10.9 + 3.7 months, P < 0.05). First-year hemorrhage episodes were similar in the two groups (0.08 ± 0.4 and 0.03 ± 0.2, respectively, P = 0.2). In a multivariate regression analysis, CKD was associated with increased risks of first year MACE (OR 2.1; 95% confidence interval 1.0-4.3, P < 0.001). Conclusions: PCI with drug-eluting balloons was associated with increased cardiovascular morbidity and mortality in patients with than without CKD. However, rates of target lesion revascularization were similar in the two groups. Shorter duration of dual anti-platelet therapy was observed in the CKD group. Keywords: Drug-eluting stents, Chronic kidney disease, Drug-eluting balloons, Percutaneous coronary intervention, Dual anti-platelet therapy, Cardiovascular mortality, In-stent restenosis, Ischemic heart disease, Target lesion revascularization
* Correspondence: [email protected] † Michael Jonas and Maayan Kagan contributed equally to this work. 2 Department of Nephrology and Hypertension, Kaplan Medical Center, Hebrew University School of Medicine, Pasternak St. POB1, 76100 Rehovot, Israel Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party ma
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