2007 JASN IMPACT FACTOR 7.111	HOME   AUTHOR INFO   EDITORIAL BOARD   SUBSCRIBE   FEEDBACK   ALERTS   HELP
advanced	CURRENT ISSUE	ARCHIVES	JASN Express	ONLINE SUBMISSION

This Article Full Text Full Text (PDF) All Versions of this Article: ASN.2005090958v1 17/8/2322    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Yasuda, K. Articles by Matsuo, S. Search for Related Content PubMed PubMed Citation Articles by Yasuda, K. Articles by Matsuo, S.

Comparison of Percutaneous Coronary Intervention with Medication in the Treatment of Coronary Artery Disease in Hemodialysis Patients

Kaoru Yasuda^*,, Hirotake Kasuga^*, Toru Aoyama, Hiroshi Takahashi, Takanobu Toriyama, Yasumasa Kawade^*, Shigejiro Iwashima^*, Shigeki Yamada^*, Hirohisa Kawahara^*, Shoichi Maruyama, Yukio Yuzawa, Hideki Ishii, Toyoaki Murohara and Seiichi Matsuo

^* Department of Nephrology; Cardiovascular Center, Nagoya Kyoritsu Hospital; and Departments of; Nephrology; and Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

Address correspondence to:Dr. Shoichi Maruyama, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showaku, Nagoya 466-8550, Japan. Phone: +81-52-744-2192; Fax: +81-52-744-2209; marus{at}med.nagoya-u.ac.jp

Received for publication September 15, 2005. Accepted for publication May 29, 2006.

It has been reported that percutaneous coronary intervention (PCI) is beneficial for coronary artery disease (CAD) among the general population. However, its effects in patients who are on hemodialysis (HD) remain unclear. A prospective cohort study was performed to clarify whether PCI has a therapeutic advantage over medical therapy among HD patients with CAD. A follow-up study to 5 yr was conducted among 259 HD patients with ischemic heart disease. Mean follow-up was 39 mo. Patients were divided into three groups: 122 patients without significant stenosis, 88 patients who had significant stenosis and were treated with PCI, and 49 patients who had significant stenosis and were treated with medication only. The primary end point was cardiac death, and the secondary end point was all-cause death. The results showed that the 5-yr cardiac survival rate was 41.6% in the medication group, 77.1% in the PCI group (P = 0.0006), and 84.5% in the nonstenosis group (P < 0.0001). The 5-yr all-cause survival rate was 19.3% in the medication group, 48.4% in the PCI group (P = 0.004), and 64.3% in the nonstenosis group (P < 0.0001). Even after adjustment for other risk factors, effects of PCI on the risk for cardiac and all-cause death remained significant and independent (odds ratio 0.14; 95% confidence interval 0.08 to 0.25, P = 0.0006; and odds ratio 0.37; 95% confidence interval 0.26 to 0.54, P = 0.0062, respectively). Results were consistent when the therapeutic effect of PCI or medication was analyzed using propensity-matched patients. These data suggested that PCI could improve the prognosis of HD patients with CAD. PCI would be recommended for HD patients with CAD.

This article has been cited by other articles:

				H. Ishii, Y. Kumada, T. Toriyama, T. Aoyama, H. Takahashi, T. Amano, Y. Yasuda, Y. Yuzawa, S. Maruyama, S. Matsuo, et al. Aortic valvular calcification predicts restenosis after implantation of drug-eluting stents in patients on chronic haemodialysis Nephrol. Dial. Transplant., December 15, 2008; (2008) gfn685v1. [Abstract] [Full Text] [PDF]

				Y. Kumada, T. Aoyama, H. Ishii, M. Tanaka, Y. Kawamura, H. Takahashi, T. Toriyama, T. Aoyama, Y. Yuzawa, S. Maruyama, et al. Long-term outcome of percutaneous transluminal angioplasty in chronic haemodialysis patients with peripheral arterial disease Nephrol. Dial. Transplant., December 1, 2008; 23(12): 3996 - 4001. [Abstract] [Full Text] [PDF]

				R. Ranpuria, M. Hall, C. T. Chan, and M. Unruh Heart rate variability (HRV) in kidney failure: measurement and consequences of reduced HRV Nephrol. Dial. Transplant., February 1, 2008; 23(2): 444 - 449. [Abstract] [Full Text] [PDF]

Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673