轻度或中度慢性肾脏疾病对冠状动脉再狭窄发生率的影响:来自PRESTO试验的结果

来源 :世界核心医学期刊文摘(心脏病学分册) | 被引量 : 0次 | 上传用户:xigongdaxigongda
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The goal of this study was to determine if restenosis is increased in mild and moderate chronic kidney disease (CKD) patients after percutaneous coronary intervention (PCI). Mortality is increased in CKD after PCI. Restenosis may contribute to increased late mortality. We analyzed 11,187 patients with a creatinine >1.8 mg/dl from the Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) trial, grouped by estimated creatinine clearance(CrCl)(< 60, 60 to 89, >89ml/min). The Cox proportional hazards models investigated the association between CrCl group and death, myocardial infarction, and target vessel revascularization(TVR). Generalized estimating equation regression models determined the association between CrCl group and lesion-specific restenosis. At 30 days, therewas no difference in myocardial infarction, death, or TVR between the CrCl groups. At nine months, mortality was higher in the lowest CrCl group(2.2%, 1.2%, 0.8%; p >0.001), which was no longer significant after adjusting for confounding variables. Myocardial infarction and TVR were not different between the groups. In patients undergoing protocol follow-up angiography, restenosis(< 50%) was not increased with CKD(32%, 32%, 37%; p=0.02). Mortality nine months after PCI is mildly increased in mild or moderate CKD patients. However, restenosis is not and does not account for the increased mortality. The goal of this study was to determine if restenosis is increased in mild and moderate chronic kidney disease (CKD) patients after percutaneous coronary intervention (PCI). Mortality is increased in CKD after PCI. patients with a creatinine> 1.8 mg / dl from the Prevention of REStenosis with Tranilast and its Outcomes (PRESTO) trial, grouped by estimated creatinine clearance (CrCl) (<60, 60 to 89,> 89 ml / min). The Cox proportional hazards models investigated the association between CrCl group and death, myocardial infarction, and target vessel revascularization (TVR). Generalized estimating equation regression models determined the association between CrCl group and lesion-specific restenosis. At 30 days, therewas no difference in myocardial infarction, death , or TVR between the CrCl groups. At nine months, mortality was higher in the lowest CrCl group (2.2%, 1.2%, 0.8%; p> 0.001), which was no longer significant afte In patients undergoing protocol follow-up angiography, restenosis (<50%) was not increased with CKD (32%, 32%, 37%; p = 0.02 ), Mortality nine months after PCI is mildly increased in mild or moderate CKD patients. However, restenosis is not and does not account for the increased mortality.
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