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首页> 外文期刊>The American Journal of Cardiology >Comparison of outcomes using the sirolimus-eluting stent in calcified versus non-calcified native coronary lesions in patients on-versus not on-chronic hemodialysis (from the j-Cypher Registry)
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Comparison of outcomes using the sirolimus-eluting stent in calcified versus non-calcified native coronary lesions in patients on-versus not on-chronic hemodialysis (from the j-Cypher Registry)

机译：使用西罗莫司洗脱支架对钙化或非钙化天然冠状动脉病变患者进行非连续性血液透析的结果比较（来自j-Cypher Registry）

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摘要

The impact of lesion calcium on long-term outcomes after drug-eluting stent implantation has not been adequately addressed. In 10,595 patients (16,803 lesions) who were exclusively treated with sirolimus-eluting stents in the j-Cypher registry, 5-year outcomes were compared between patients with ≥1 lesion with moderate or severe calcification (the calcium group) and those with noncalcified lesions only (the noncalcium group). Analyses were stratified by hemodialysis (HD) status (non-HD stratum [calcium n = 3,191, noncalcium n = 6,824] and HD stratum [calcium n = 415, noncalcium n = 165]). Adjusted risk in the calcium group for death and target lesion revascularization was significant in the non-HD stratum (hazard ratio [HR] 1.34, 95% confidence interval [CI] 1.18 to 1.52, p <0.0001, and HR 1.2, 95% CI 1.07 to 1.36, p = 0.003) and the HD stratum (HR 1.4, 95% CI 1.06 to 1.86, p = 0.02, and HR 2.25, 95% CI 1.51 to 3.36, p <0.0001). Risk for definite stent thrombosis tended to be higher in the calcium group in the HD stratum (HR 5.05, 95% CI 0.66 to 38.9, p = 0.12) but not in then non-HD stratum (HR 1.16, 95% CI 0.81 to 1.67, p = 0.41). The use of rotational atherectomy in patients with severe calcification did not have a significant impact on the cumulative incidence of target lesion revascularization in the non-HD stratum (17.7% [n = 268] with vs 18.2% [n = 588] without rotational atherectomy, p = 0.68) and the HD stratum (54.7% [n = 115] with vs 51.9% [n = 118] without rotational atherectomy, p = 0.19). In conclusion, regardless of HD status, patients with calcified lesions have increased long-term risk for death and target lesion revascularization after sirolimus-eluting stent implantation.
机译：药物洗脱支架植入后病变钙对长期预后的影响尚未得到充分解决。在j-Cypher注册表中，仅使用西罗莫司洗脱支架治疗的10,595例患者（16,803个病变）中，对≥1个病变的中度或重度钙化（钙组）患者和未钙化病变的5年结果进行了比较仅（非钙基）。通过血液透析（HD）状态对分析进行分层（非HD层[钙n = 3,191，非钙n = 6,824]和HD层[钙n = 415，非钙n = 165]）。钙组死亡和目标病变血运重建的调整后风险在非HD阶层中显着（危险比[HR] 1.34，95％置信区间[CI] 1.18至1.52，p <0.0001，HR 1.2，95％CI 1.0到1.36，p = 0.003）和HD阶层（HR 1.4，95％CI 1.06至1.86，p = 0.02，HR 2.25，95％CI 1.51至3.36，p <0.0001）。 HD组钙水平明确的支架内血栓形成的风险往往较高（HR 5.05，95％CI 0.66至38.9，p = 0.12），而非HD组钙水平较高（HR 1.16，95％CI 0.81至1.67） ，p ＝ 0.41）。在严重钙化患者中使用旋磨术对非HD层目标病变血运重建的累积发生率没有显着影响（17.7％[n = 268]相对于未旋磨术的18.2％[n = 588] ，p = 0.68）和HD层（有旋转斑块切除术的HD层为54.7％[n = 115]，有51.9％[n = 118]，p = 0.19）。总之，无论HD状态如何，钙化病变的患者在西罗莫司洗脱支架植入后长期死亡的风险和目标病变血运重建的风险均增加。

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