Clinical Efficacy of Percutaneous Transluminal Coronary Angioplasty (PTCA) in Chronic Renal Failure.
- Author:
Ji Eun OH
1
;
Hyun Lee KIM
;
Ki Young NA
;
Woo Kyung JUNG
;
Se Il OH
;
In Ho CHAE
;
Yon Su KIM
;
Cu Rie AHN
;
Jin Suk HAN
;
Suhng Gwon KIM
;
Jung Sang LEE
Author Information
1. Department of Internal Medicine, College of Medicine, Seoul National University, Seoul, Korea. jsleemd@plaza.snu.ac.kr
- Publication Type:Original Article
- Keywords:
Chronic renal failure;
Percutaneous transluminal coronary angioplasty (PTCA);
Restenosis
- MeSH:
Angiography;
Angioplasty, Balloon, Coronary*;
Case-Control Studies;
Creatinine;
Diabetes Mellitus;
Dialysis;
Female;
Follow-Up Studies;
Humans;
Kidney Failure, Chronic*;
Male;
Mortality;
Myocardial Ischemia;
Renal Dialysis;
Renal Insufficiency;
Reperfusion;
Retrospective Studies;
Stents
- From:Korean Journal of Nephrology
2002;21(2):295-302
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Ischemic heart disease has become more important in regard to mortality in hemodialysis patients. Although PTCA has been used for the treatment of ischemic heart disease, its result has little been reported in chronic renal failure(CRF) patients not in maintenance dialysis. We examined the therapeutic outcome of PTCA in CRF group in comparison with that in control group with normal renal function. METHODS: In a retrospective case-control study, 15 patients with CRF(Scr >or=1.4 mg/dL) were compared with 29 sex, age and diabetes mellitus matched controls without renal disease who had been randomly selected from the PTCA registry of our institution. Restenosis was evaluated by follow-up angiography or recurrent angina. Twenty-two PTCAs were performed over 26 stenotic lesions in CRF group, and thirty-nine PTCAs undergone over 56 lesions in control group. RESULTS: CRF group consisted of 11 men and 4 women with a mean age of 59.2+/-9.2(mean+/-SD) years and a mean serum creatinine of 3.8+/-2.4 mg/ dL. Cause of renal failure was diabetes mellitus in 11 cases(73%). Angiographic lesion success was confirmed in 17(65%) out of the 26 stenotic sites and stents were inserted successfully in the other nine lesions. Restenosis was confirmed by angiography in 10 lesions(38.5%) over a mean of seven months and suspected by recurrent angina in 6 lesions(23.1%), so overall restenosis rate was 61.6% in CRF group. Risk of restenosis was little different compared with control group in single- and double vessel disease, but increased up to 89% in triple vessel disease in CRF in contrast with control group. Among CRF group patients with serum creatinine >or=2.5 mg/dL showed much increased restenosis rate(77%) compared with those with serum creatinine <2.5 mg/dL (46%). CONCLUSION: Restenosis rate significantly increased in CRF patients who have multivessel disease or advanced renal failure, so other reperfusion therapy should be considered for them.
