Sirolimus- vs. paclitaxel-eluting stent to coronary intervention in dialysis patients

BackgroundPatients on maintenance hemodialysis (HD) are at high risk for restenosis after percutaneous coronary intervention (PCI) even if treated with a sirolimus-eluting stent (SES). The aim of this study was to compare the effects of SES and paclitaxel-eluting stent (PES) in preventing restenosis in HD patients with coronary artery disease.MethodsA total of 100 consecutive patients on HD who underwent PCI were enrolled into the study. They were randomly assigned to receive either SES or PES. We compared follow-up angiographic outcomes between the SES and PES groups at 8-month follow-up.ResultsThe angiographical restenosis rate, defined as % diameter stenosis > 50% at 8-month follow-up, was 19.7% in the SES group and 20.0% in the PES group (p = 0.97). Late loss was also similar between the two groups (0.49 ± 0.70 mm vs. 0.48 ± 0.91 mm, P = 0.94). There were no significant differences in the rates of all-cause death, non-fatal myocardial infarction, or TLR due to stent restenosis-induced ischemia between the two groups (2.0% vs. 4.0%, p = 0.56, 2.0% vs. 4.0%, p = 0.56, and 16.0% vs. 12.0%, p = 0.57, respectively).ConclusionsThere was no significant difference in angiographical outcome at 8-month follow-up between HD patients treated with SES and PES. Even if treated with DES including SES and PES, patients on HD are at high risk of restenosis after PCI.