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Eficácia e segurança dos stents farmacológicos em pacientes com insuficiência renal crônica

Objectives. We sought to evaluate the safety and efficacy of Drug eluting stents (DES) in patients with significant CKD in a real world registry Background. Patients with chronic kidney disease (CKD) who undergo percutaneous coronary angioplasty have higher rates of target lesion revascularization (TLR) and mortality. DES are associated with a lower rate of restenosis compared to bare metal stents (BMS), although in patients with CKD data on DES efficacy and safety is limited. Methods. A total of 504 patients who underwent percutaneous coronary intervention with DES in two centers were included in this study. Outcomes were stratified on the basis of the presence of CKD, defined as a baseline glomerular filtration rate <60ml/min/1.73m². Results. The mean follow-up was 22.7 months. CKD was present in 165 patients (32.7%). Patients with CKD were older, had more hypertension and diabetes. CKD patients presented increased incidence of death (12.3% vs. 2.4%, p<0.001) and myocardial infarction (MI) (7.4% vs. 3.3%, p=0.04) compared to patients without CKD. TLR rates were similar between groups (4.8% vs. 5.6%, p=0.7, CKD and no CKD patients, respectively). Independent predictors of death were CKD (HR 6.93; 2.4 – 19.5, p<0.001), current smoking (HR 3.66; 1.20 – 11.10, p=0.02) and diabetes (HR 2.66; 1.03 – 6.60, p=0.045). Conclusion. In this real-world registry, coronary intervention with DES in patients with CKD was associated with similar TLR compared to patients without CKD, demonstrating the efficacy of DES in preventing in-stent restenosis in this patient population. CKD was related to significantly increased MI and mortality rates.

Identiferoai:union.ndltd.org:IBICT/oai:lume.ufrgs.br:10183/17433
Date January 2008
CreatorsBlaya, Patrícia
ContributorsCaramori, Paulo Ricardo Avancini
Source SetsIBICT Brazilian ETDs
LanguagePortuguese
Detected LanguageEnglish
Typeinfo:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis
Formatapplication/pdf
Sourcereponame:Biblioteca Digital de Teses e Dissertações da UFRGS, instname:Universidade Federal do Rio Grande do Sul, instacron:UFRGS
Rightsinfo:eu-repo/semantics/openAccess

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