Clinical characteristics and prognosis of elderly hemodialysis patients with end-stage renal disease undergoing drug-eluting stent implantation
10.3969/j.issn.1009-0126.2024.05.002
- VernacularTitle:老年终末期肾病血液透析患者接受药物洗脱支架置入治疗的临床特点和预后分析
- Author:
Yuanyuan FENG
1
;
Xing LIU
;
Xue ZHANG
;
Tong LIU
;
Rha SEUNG-WOON
;
Kangyin CHEN
Author Information
1. 300211 天津医科大学第二医院心脏内科
- Keywords:
nephrosis;
continuous renal replacement therapy;
drug-eluting stents;
prognosis;
fore-casting;
major adverse cardiovascular events
- From:
Chinese Journal of Geriatric Heart Brain and Vessel Diseases
2024;26(5):485-489
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effect of end-stage renal disease(ESRD)hemodialysis(HD)on the prognosis of elderly patients undergoing drug-eluting stent(DES)implantation.Methods A retrospective trial was conducted on 4219 consecutive patients(＞60 years old)undergoing DES treatment at Guro Hospital of Korea University from March 2003 to July 2021,and those with GFR ≥ 1 5 ml/(min·1.73 m2)but not on dialysis were assigned into the non-ESRD group(n=4102)and the others on dialysis into the ESRD group(n=117).Based on their baseline data,a propensity score matching(PSM)model was established,including 183 cases of the non-ESRD group and 99 cases of the ESRD group.The patients were followed up for 1,3 and 5 years,and the incidences of MACE and other endpoint events were recorded during the period.Kaplan-Meier sur-vival curve was plotted,and PSM and multivariate Cox regression models were employed to verify the endpoint events.Results Before PSM,the elderly ESRD group had obviously larger propor-tions of hypertension,diabetes,peripheral vascular disease and other diagnoses than the elderly non-ESRD group(P＜0.01).Univariate Cox regression analysis showed that ESRD was a risk fac-tor for all-cause mortality in the elderly patients at 1,3 and 5 years after DES implantation(P＜0.05,P＜0.01);a risk factor for MACE at 3 and 5 years after implantation(HR=2.67,95％CI:1.73-4.10,P=0.000;HR=2.65,95％CI:1.79-3.90,P=0.000);and a risk factor for develo-ping TVR,TLR,NTVR and revascularization at 5 years after surgery(P＜0.05,P＜0.01).Kaplan-Meier survival curve showed that the incidence of MACE in the elderly ESRD group was higher than that in the elderly non-ESRD group at 5-year follow-up(Plog rank=0.006).Conclusion ESRD significantly increases the risk of long-term MACE after DES implantation in elderly patients.
