Korean Journal of Nephrology 2001;20(2):250-257.
원저 : 허혈성 심장질환을 동반한 말기신부전 환자에서 관상동맥 스텐트 시술과 우회로 이식술의 임상성적 (The Clinical Outcomes of Coronary Stenting and Coronary Artery Bypass Grafting in ESRD Patients with Ischemic Heart Disease)
이준승(Joon Seung Lee),장재원(Jai Weon Chang),이미숙(Mee Sook Lee),장상필(Sang Pil Chang),박성욱(Seong Wook Park),이철환(Cheol Whan Lee),송현(Hyun Song),박정식(Jung Sik Park)
Abstract
The purpose of this study was firstly, to evaluate the efficacy of coronary stenting in ESRD patients compared with non uremic patients and secondly, to compare the perioperative mortality of coronary ar- tery bypass grafting(CABG) in ESRD patients with that in non-uremic patients exhibiting a similar de- gree of left ventricular function. We examined the clinical restenosis of coronary stenting and 30 day mortality rate after CABG in this retrospective, casecontrolled study. The case histories of twenty-five ESRD patients with ischemic heart disease(IHD) and twenty-five non-uremic IHD patients matched for age, sex, ejection fraction and number of implanted stents, who had undergone first, elective, primarily successful coronary stenting were reviewed. The case of histories of another sixteen ESRD patients with IHD and sixteen non-uremic IHD patients matched for age, sex, ejection fraction and number of grafted vessels, who had undergone first elective CABG were also reviewed. Clinical restenosis developed in nine of the twenty-five ESRD patients and in eight of the twenty-five non-uremic patients after coronary stenting within follow up periods of 16.9±14.5 months and 17.6±14.6 months, respectively. There was no significant difference in the cumulative clinical restenosis free curves between the two groups(p=0.79). Three out of sixteen for the ESRD patients and one out of sixteen for the non-uremic patients died in 30 days after CABG, follow up periods being 11.3±9.6 months and 11.1±8.9 months, respectively. The perioperative mortality did not differ between the two groups(p=0.28). We conclude that coronary stenting in ESRD patients is as effective as in non-uremic patients regarding initial coronary revascularization and perioperative mortality rate of CABG in ESRD patients is not significantly higher compared with non-uremic patients when Left ventricular function is matched.
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