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Severe Renal Insufficiency Is the Strongest Predictor of Mortality After Drug-Eluting Stent Implantation: Presented at SCAI By Carole VanSickle Ellis SAN DIEGO -- May 9, 2010 -- Long-term mortality after drug-eluting stent (DES) implantation may be best predicted by severe renal insufficiency, according to a study presented May 7 here at the 33rd Annual Scientific Sessions of the Society for Cardiovascular Angioplasty and Interventions (SCAI). Ren Kawaguchi, MD, Gunma Prefectural Cardiovascular Centre, Maebashi Gunma, Japan, noted that while DES implantation has reduced problems like restenosis and target lesion revascularisation (TLR), long-term mortality rates have not improved. Dr. Kawaguchi and colleagues enrolled 558 consecutive patients who were discharged from their centre after DES implantation of a sirolimus-eluting stent to determine predictors of long-term mortality. Follow-up angiography was set for 6 and 9 months after the procedure, while clinical data was collected at time periods of 1 month, 6 months, 1 year, 2 years, and 3 years after the patients had been discharged. The patients were on a daily antiplatelet regimen of aspirin 100 mg (indefinitely) and ticlopidine 200 mg or clopidogrel 75 mg for 3 months. Of the 558 patients involved, 86 had acute myocardial infarction (MI) and 428 had angina. Mean age was 67.7 +- 10.2 years. Severe renal insufficiency (estimated glomerular filtration rate <40 mL/min) was observed in 110 of the patients (19.7%). In the first year of follow-up 10 patients died; 32 had TLR; 2 had stent thrombosis; and 3 patients were observed to have MI. Through the 3-year follow-up, 19 deaths were observed (3.41%). At 1 year, the mortality rate of patients with DES implantation was 1.79% and at 3 years, it was 3.41%. At 3-year follow-up, heart failure, presence of peripheral artery disease, haemodialysis, and severe renal insufficiency were all correlated with death. However, "multivariate analysis identified that severe renal insufficiency was the independent strongest predictor of both death within 1 year and up to 3 years after DES implantation," said Dr. Kawaguchi. [Presentation title: Long Term Mortality and Predictors of Death Risk of the Patients After Drug-Eluting Stent Implantation. Abstract D-045] E-mail this page to a friend or colleague! To print, use this version