Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
8
pubmed:dateCreated
2008-10-20
pubmed:abstractText
The presence of even mild renal insufficiency is usually associated with an increased rate of cardiovascular events after coronary stenting. The aim of this study was to evaluate the impact of mild to moderate renal insufficiency on the chronic vascular responses to the implantation of paclitaxel-eluting stents (PES; Taxus) and bare-metal stents (BMS). In the TAXUS IV, TAXUS V, and TAXUS VI trials, patients with serum creatinine levels >2.0 mg/dl were excluded. In the present analysis, 816 patients with serum creatinine levels <or=2.0 mg/dl had intravascular ultrasound images acquired after the procedures and/or at 9-month follow-up (406 with PES, 410 with BMS). Patients were stratified by level of creatinine clearance (Ccr; group 1: Ccr <40; group 2: 40 <or=Ccr <60; group 3: 60 or/=Ccr <80; group 4: Ccr >or=80 ml/min/1.73 m(2)). For all levels of Ccr, patients with PES compared with those with BMS had less intimal hyperplasia area (group 1: 0.97 +/- 0.98 vs 2.94 +/- 1.89; group 2: 0.94 +/- 0.86 vs 2.30 +/- 1.21; group 3: 0.99 +/- 1.02 vs 2.53 +/- 1.29; group 4: 0.87 +/- 0.95 vs 2.12 +/- 1.29 mm(2), all p values <0.0001) and greater increases in peristent plaque and media area (group 1: 0.90 +/- 0.98 vs -0.02 +/- 0.98 mm(2), p = 0.03; group 2: 0.57 +/- 1.43 vs 0.20 +/- 1.14 mm(2), p = 0.11; group 3: 1.20 +/- 1.95 vs 0.02 +/- 1.17, p <0.0001; group 4: 0.35 +/- 1.44 vs -0.19 +/- 1.08 mm(2), p = 0.08). Neointimal growth and vessel remodeling were not affected by variations in Ccr after either BMS or PES implantation over the range studied. The incidence of incomplete stent apposition at follow-up was lowest in patients with the greatest renal impairment after BMS and PES implantation. In conclusion, neointimal proliferation was less prominent and expansive vessel remodeling was more prominent after PES than BMS implantation, independent of the severity of renal dysfunction.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Oct
pubmed:issn
1879-1913
pubmed:author
pubmed:issnType
Electronic
pubmed:day
15
pubmed:volume
102
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1009-16
pubmed:meshHeading
pubmed-meshheading:18929701-Aged, pubmed-meshheading:18929701-Blood Vessel Prosthesis Implantation, pubmed-meshheading:18929701-Coated Materials, Biocompatible, pubmed-meshheading:18929701-Coronary Circulation, pubmed-meshheading:18929701-Coronary Disease, pubmed-meshheading:18929701-Creatinine, pubmed-meshheading:18929701-Female, pubmed-meshheading:18929701-Follow-Up Studies, pubmed-meshheading:18929701-Humans, pubmed-meshheading:18929701-Male, pubmed-meshheading:18929701-Metals, pubmed-meshheading:18929701-Middle Aged, pubmed-meshheading:18929701-Paclitaxel, pubmed-meshheading:18929701-Prospective Studies, pubmed-meshheading:18929701-Renal Insufficiency, pubmed-meshheading:18929701-Severity of Illness Index, pubmed-meshheading:18929701-Stents, pubmed-meshheading:18929701-Time Factors, pubmed-meshheading:18929701-Treatment Outcome, pubmed-meshheading:18929701-Tubulin Modulators, pubmed-meshheading:18929701-Ultrasonography, Interventional, pubmed-meshheading:18929701-Vascular Resistance
pubmed:year
2008
pubmed:articleTitle
Impact of mild or moderate renal insufficiency on the intravascular ultrasonic analysis of chronic vascular response to paclitaxel-eluting and bare-metal stents (from the TAXUS IV, V, and VI trials).
pubmed:affiliation
Columbia University Medical Center, New York, New York, USA.
pubmed:publicationType
Journal Article, Comparative Study, Randomized Controlled Trial, Multicenter Study