Randomized comparison of xience v and multi-link vision coronary stents in the same multivessel patient with chronic kidney disease (RENAL-DES) study

Carlo Trani, Fabrizio Tomai, Flavio Ribichini, Leonardo De Luca, Alessandro Petrolini, Anna S. Ghini, Luca Weltert, Carmen Spaccarotella, Igino Proietti, Francesco Nudi, Michele Pighi, Corrado Vassanelli

Risultato della ricerca: Contributo in rivistaArticolo in rivista

31 Citazioni (Scopus)

Abstract

BACKGROUND - : Percutaneous coronary interventions in patients with chronic kidney disease have shown suboptimal results. Drug-eluting stents (DES) might reduce the rate of target vessel revascularization in comparison with bare-metal stents (BMS) in patients with chronic kidney disease. However, given the multiple concomitant individual variables present in such patients, the comparison of neointimal growth after percutaneous coronary intervention is complex and difficult to assess. METHODS AND RESULTS - : Randomized Comparison of Xience V and Multi-Link Vision Coronary Stents in the Same Multivessel Patient with Chronic Kidney Disease (RENAL-DES) was a prospective, randomized, multicenter study to directly compare the efficacy in the prevention of clinical restenosis of everolimus-eluting stent (Xience V) and BMS with an identical design (Multi-Link Vision), both implanted in the same patient with multivessel coronary artery disease and chronic kidney disease (estimated glomerular filtration rate <60 mL/min). The primary end point of the study was the ischemia-driven target vessel revascularization as detected with myocardial scintigraphy at 12 months. In 215 patients, 512 coronary vessels were successfully treated with the randomly assigned DES (n=257) or BMS (n=255). At 1 year, the rate of ischemia-driven target vessel revascularization for DES and BMS groups was 2.7% (95% confidence interval, 1.1%-5.6%) and 11.4% (95% confidence interval, 7.8% to 16%), respectively, P<0.001. For the multivariate analysis, independent predictors of the ischemia-driven target vessel revascularization were BMS implantation (odds ratio, 4.95; 95% confidence interval, 2.1-11.6; P<0.001) and vessel size (odds ratio, 0.32; 95% confidence interval, 0.1-0.7; P=0.006). CONCLUSIONS - : This is the first randomized trial showing a reduction of clinical restenosis with a new-generation DES in comparison with a BMS of equal design, in patients who have chronic kidney disease with multivessel coronary artery disease. © 2013 American Heart Association, Inc.
Lingua originaleEnglish
pagine (da-a)1104-1112
Numero di pagine9
RivistaCirculation
Volume129
DOI
Stato di pubblicazionePubblicato - 2014

Keywords

  • Aged
  • Aged, 80 and over
  • Comorbidity
  • Coronary Angiography
  • Coronary Artery Disease
  • Drug-Eluting Stents
  • Drug-eluting stents
  • Endpoint Determination
  • Everolimus
  • Female
  • Glomerular Filtration Rate
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Percutaneous Coronary Intervention
  • Prospective Studies
  • Renal Insufficiency, Chronic
  • Risk Factors
  • Sirolimus
  • Stents
  • Treatment Outcome
  • chronic
  • percutaneous coronary intervention
  • renal insufficiency

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