Skip to main content
SpringerLink
Log in

Outcomes after drug-coated balloon interventions for de novo coronary lesions in the patients on chronic hemodialysis

  • Original Article
  • Published:
Heart and Vessels Aims and scope Submit manuscript

Abstract

The impact of drug-coated balloon (DCB) on hemodialysis (HD) patients with coronary lesions remains unclear. This study aimed to compare outcomes after DCB treatment between HD and non-HD patients with de novo coronary lesions. A total of 235 consecutive patients who electively underwent DCB treatment for de novo coronary lesions were included (HD group: n = 100; non-HD group: n = 135). Angiographic follow-up was performed 6 months after the procedure. Patients were clinically followed up for 2 years. The incidence rates of target lesion revascularization (TLR) and major adverse cardiac events (MACE) were investigated. Diabetes and a history of coronary bypass grafting were more frequent in the HD group than in the non-HD group (69.0% vs. 50.7%, p = 0.007, and 24.0% vs 9.1%, p = 0.013, respectively). The reference diameter and pre-procedural diameter stenosis were greater in the HD group than in the non-HD group (2.49 mm vs. 2.24 mm, p = 0.007, and 65.9% vs. 59.6%, p = 0.015, respectively). Calcification was observed in 65.5% of all lesions, and rotational atherectomy was performed in 30.2% patients. The average diameter of the DCB was 2.51 mm (2.57 mm, HD group vs. 2.47 mm, non-HD group, p = 0.14). Although post-procedural diameter stenosis was similar between the groups, late lumen loss on follow-up angiography was larger in HD patients than in non-HD patients (0.27 mm vs. − 0.03 mm, p = 0.0009). The 2-year rates of freedom from TLR and MACE were lower in HD patients than in non-HD patients [79.3% vs. 91.7%, hazard ratio (HR) 2.76, 95% confidence interval (CI) 1.23–6.77, p = 0.014; and 61.6% vs. 89.4%, HR 4.60, 95% CI 2.30–10.2, p < 0.001, respectively]. In conclusion, the rates of TLR and MACE after DCB treatment were higher in HD patients than in non-HD patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Herzog CA, Ma JZ, Collins AJ (1998) Poor long-term survival after acute myocardial infarction among patients on long-term dialysis. N Engl J Med 339:799–805

    Article  CAS  Google Scholar 

  2. Parfrey PS, Foley RN (1999) The clinical epidemiology of cardiac disease in chronic renal failure. J Am Soc Nephrol 10:1606–1615

    Article  CAS  Google Scholar 

  3. Cheung AK, Sarnak MJ, Yan G, Dwyer JT, Heyka RJ, Rocco MV, Teehan BP, Levey AS (2000) Atherosclerotic cardiovascular disease risks in chronic hemodialysis patients. Kidney Int 58:353–362

    Article  CAS  Google Scholar 

  4. Herzog CA, Ma JZ, Collins AJ (2002) Comparative survival of dialysis patients in the United States after coronary angioplasty, coronary artery stenting, and coronary artery bypass surgery and impact of diabetes. Circulation 106:2207–22011

    Article  Google Scholar 

  5. Otsuka Y, Ishiwata S, Inada T, Kanno H, Kyo E, Hayashi Y, Fujita H, Michishita I (2011) Comparison of haemodialysis patients and non-haemodialysis patients with respect to clinical characteristics and 3-year clinical outcomes after sirolimus-eluting stent implantation: insights from the Japan multi-centre post-marketing surveillance registry. Eur Heart J 32:829–837

    Article  CAS  Google Scholar 

  6. Moses JW, Leon MB, Popma JJ, Fitzgerald PJ, Holmes DR, O’Shaughnessy C, Caputo RP, Kereiakes DJ, Williams DO, Teirstein PS, Jaeger JL, Kuntz RE, Investigators SIRIUS (2003) Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 349:1315–1323

    Article  CAS  Google Scholar 

  7. Stone GW, Moses JW, Ellis SG, Schofer J, Dawkins KD, Morice MC, Colombo A, Schampaert E, Grube E, Kirtane AJ, Cutlip DE, Fahy M, Pocock SJ, Mehran R, Leon MB (2007) Safety and efficacy of sirolimus- and paclitaxel-eluting coronary stents. N Engl J Med 356:998–1008

    Article  CAS  Google Scholar 

  8. Stone GW, Moses JW, Ellis SG, Schofer J, Dawkins KD, Morice MC, Colombo A, Schampaert E, Grube E, Kirtane AJ, Cutlip DE, Fahy M, Pocock SJ, Mehran R, Leon MB (2008) Comparison of an everolimus-eluting stent and a paclitaxel-eluting stent in patients with coronary artery disease: a randomized trial. JAMA 299:1903–1913

    Article  CAS  Google Scholar 

  9. Stone GW, Rizvi A, Sudhir K, Newman W, Applegate RJ, Cannon LA, Maddux JT, Cutlip DE, Simonton CA, Sood P, Kereiakes DJ, Investigators SPIRITIV (2011) Randomized comparison of everolimus- and paclitaxel-eluting stents. 2-year follow-up from the SPIRIT (clinical evaluation of the XIENCE V everolimus eluting coronary stent system) IV trial. J Am Coll Cardiol 58:19–25

    Article  Google Scholar 

  10. Bangalore S, Kumar S, Fusaro M, Amoroso N, Attubato MJ, Feit F, Bhatt DL, Slater J (2012) Short- and long-term outcomes with drug-eluting and bare-metal coronary stents: a mixed-treatment comparison analysis of 117 762 patient-years of follow-up from randomized trials. Circulation 125:2873–2891

    Article  CAS  Google Scholar 

  11. Nakazawa G, Tanabe K, Aoki J, Yamamoto H, Higashikuni Y, Onuma Y, Yachi S, Nakajima H, Hara K (2007) Impact of renal insufficiency on clinical and angiographic outcomes following percutaneous coronary intervention with sirolimus-eluting stents. Catheter Cardiovasc Interv 69:808–814

    Article  Google Scholar 

  12. Ichimoto E, Kobayashi Y, Iijima Y, Kuroda N, Kohno Y, Komuro I (2010) Long-term clinical outcomes after sirolimus-eluting stent implantation in dialysis patients. Int Heart J 51:92–97

    Article  Google Scholar 

  13. Ikari Y, Kyono H, Isshiki T, Ishizuka S, Nasu K, Sano K, Okada H, Sugano T, Uehara Y (2015) Usefulness of everolimus-eluting coronary stent implantation in patients on maintenance hemodialysis. Am J Cardiol 116:872–876

    Article  Google Scholar 

  14. Unverdorben M, Kleber FX, Heuer H, Figulla HR, Vallbracht C, Leschke M, Cremers B, Hardt S, Buerke M, Ackermann H, Boxberger M, Degenhardt R, Scheller B (2010) Treatment of small coronary arteries with a paclitaxel-coated balloon catheter. Clin Res Cardiol 99:165–174

    Article  CAS  Google Scholar 

  15. Wöhrle J, Zadura M, Möbius-Winkler S, Leschke M, Opitz C, Ahmed W, Barragan P, Simon JP, Cassel G, Scheller B (2012) SeQuentPlease World Wide Registry: clinical results of SeQuent please paclitaxel-coated balloon angioplasty in a large-scale, prospective registry study. J Am Coll Cardiol 60:1733–1738

    Article  Google Scholar 

  16. Zeymer U, Waliszewski M, Spiecker M, Gastmann O, Faurie B, Ferrari M, Alidoosti M, Palmieri C, Heang TN, Ong PJ, Dietz U (2014) Prospective “real world” registry for the use of the “PCB only” strategy in small vessel de novo lesions. Heart 100:311–316

    Article  CAS  Google Scholar 

  17. Unverdorben M, Kleber FX, Heuer H, Figulla HR, Vallbracht C, Leschke M, Cremers B, Hardt S, Buerke M, Ackermann H, Boxberger M, Degenhardt R, Scheller B (2013) Treatment of small coronary arteries with a paclitaxel-coated balloon catheter in the PEPCAD I study: are lesions clinically stable from 12 to 36 months? EuroIntervention 9:620–628

    Article  Google Scholar 

  18. Mintz GS, Popma JJ, Pichard AD, Kent KM, Satler LF, Chuang YC, Ditrano CJ, Leon MB (1995) Patterns of calcification in coronary artery disease. A statistical analysis of intravascular ultrasound and coronary angiography in 1155 lesions. Circulation 91:1959–1965

    Article  CAS  Google Scholar 

  19. Ryan TJ, Faxon DP, Gunnar RM, Kennedy JW, King SB 3rd, Loop FD, Peterson KL, Reeves TJ, Williams DO, Winters WL Jr (1988) Guidelines for percutaneous transluminal coronary angioplasty. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (subcommittee on percutaneous transluminal coronary angioplasty). Circulation 78:486–502

    Article  CAS  Google Scholar 

  20. Kleber FX, Rittger H, Bonaventura K, Zeymer U, Wöhrle J, Jeger R, Levenson B, Möbius-Winkler S, Bruch L, Fischer D, Hengstenberg C, Pörner T, Mathey D, Scheller B (2013) Drug-coated balloons for treatment of coronary artery disease: updated recommendations from a consensus group. Clin Res Cardiol 102:785–797

    Article  CAS  Google Scholar 

  21. Ishii H, Toriyama T, Aoyama T, Takahashi H, Tanaka M, Yoshikawa D, Hayashi M, Yasuda Y, Maruyama S, Matsuo S, Matsubara T, Murohara T (2012) Percutaneous coronary intervention with bare metal stent vs. drug-eluting stent in hemodialysis patients. Circ J 76:1609–1615

    Article  Google Scholar 

  22. Venetsanos D, Lawesson SS, Panayi G, Tödt T, Berglund U, Swahn E, Alfredsson J (2018) Long-term efficacy of drug coated balloons compared with new generation drug-eluting stents for the treatment of de novo coronary artery lesions. Catheter Cardiovasc Interv 92:E317–E326

    Article  Google Scholar 

  23. Kaw D, Malhotra D (2006) Platelet dysfunction and end-stage renal disease. Semin Dial 19:317–322

    Article  Google Scholar 

  24. Rios DR, Carvalho Md, Lwaleed BA, Simões e Silva AC, Borges KB, Dusse LM, (2010) Hemostatic changes in patients with end stage renal disease undergoing hemodialysis. Clin Chim Acta 411:135–139

    Article  CAS  Google Scholar 

  25. Mintz GS, Weissman NJ (2006) Intravascular ultrasound in the drug-eluting stent era. J Am Coll Cardiol 48:421–429

    Article  Google Scholar 

  26. Kang SJ, Mintz GS, Park DW, Lee SW, Kim YH, Whan Lee C, Han KH, Kim JJ, Park SW, Park SJ (2011) Mechanisms of in-stent restenosis after drug-eluting stent implantation: intravascular ultrasound analysis. Circ Cardiovasc Interv 4:9–14

    Article  Google Scholar 

  27. Uren NG, Schwarzacher SP, Metz JA, Lee DP, Honda Y, Yeung AC, Fitzgerald PJ, Yock PG, Registry Investigators POST (2002) Predictors and outcomes of stent thrombosis: an intravascular ultrasound registry. Eur Heart J 23:124–132

    Article  Google Scholar 

  28. Ito R, Ueno K, Yoshida T, Takahashi H, Tatsumi T, Hashimoto Y, Kojima Y, Kitamura T, Morita N (2018) Outcomes after drug-coated balloon treatment for patients with calcified coronary lesions. J Interv Cardiol 31:436–441

    Article  Google Scholar 

  29. Rissanen TT, Uskela S, Siljander A, Kärkkäinen JM, Mäntylä P, Mustonen J, Eränen J (2017) Percutaneous coronary intervention of complex calcified lesions with drug-coated balloon after rotational atherectomy. J Interv Cardiol 30:139–146

    Article  Google Scholar 

  30. Ueno K, Morita N, Kojima Y, Takahashi H, Kawasaki M, Ito R, Kondo H, Minatoguchi S, Yoshida T, Hashimoto Y, Tatsumi T, Kitamura T (2019) Safety and long-term efficacy of drug-coated balloon angioplasty following rotational atherectomy for severely calcified coronary lesions compared with new generation drug-eluting stents. J Interv Cardiol 2019:9094178

    Article  Google Scholar 

  31. Jeger RV, Eccleshall S, Wan Ahmad WA, Ge J, Poerner TC, Shin ES, Alfonso F, Latib A, Ong PJ, Rissanen TT, Saucedo J, Scheller B, Kleber FX, International DCB Consensus Group (2020) Drug-coated balloons for coronary artery disease: third report of the International DCB Consensus Group. JACC Cardiovasc Interv 13:1391–1402

    Article  Google Scholar 

  32. Takahashi R, Ito Y, Takahashi H, Ishii H, Kasuga H, Mizuno M, Suzuki Y, Yuzawa Y, Maruyama S, Murohara T, Imai E, Matsuo S (2012) Combined values of serum albumin, C-reactive protein and body mass index at dialysis initiation accurately predicts long-term mortality. Am J Nephrol 36:136–143

    Article  CAS  Google Scholar 

  33. Takahashi H, Ito Y, Ishii H, Aoyama T, Kamoi D, Kasuga H, Yasuda K, Maruyama S, Matsuo S, Murohara T, Yuzawa Y (2014) Geriatric nutritional risk index accurately predicts cardiovascular mortality in incident hemodialysis patients. J Cardiol 64:32–36

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Nagoya Kyoritsu Hospital, 1-172 Hokke, Nakagawa-ku, Nagoya, Aichi, 454-0933, Japan

    Ryuta Ito, Satoru Oshima, Takashi Sakakibara & Motohiko Kakuno

  2. Department of Cardiology, Fujita Health University Bantane Hospital, Nagoya, Japan

    Hideki Ishii

  3. Department of Cardiovascular Surgery, Nagoya Kyoritsu Hospital, Nagoya, Japan

    Takuya Nakayama

  4. Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Hideki Ishii & Toyoaki Murohara

Authors
  1. Ryuta Ito
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hideki Ishii
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Satoru Oshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takuya Nakayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Sakakibara
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Motohiko Kakuno
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Toyoaki Murohara
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

RI and TN conceptualization. SO and TS methodology. HI and MK analysis and investigation. RI writing—original draft preparation. TM supervision.

Corresponding author

Correspondence to Ryuta Ito.

Ethics declarations

Conflict of interest

H.I. received lecture fees from Astellas Pharma, AstraZeneca, Bayer Pharmaceutical Co.Ltd., Chugai Pharma Inc., Daiichi-Sankyo Co., Ltd., and MSD K. K. T.M. received lecture fees from Bayer Pharmaceutical Co., Ltd., Daiichi-Sankyo Co., Ltd., Dainippon Sumitomo Pharma Co., Ltd., Kowa Co., Ltd., MSD K. K., Mitsubishi Tanabe Pharma Co., Nippon Boehringer Ingelheim Co., Ltd., Novartis Pharma K. K., Pfizer Japan Inc., Sanofi-Aventis K. K., and Takeda Pharmaceutical Co., Ltd. For the remaining authors, no conflicts are declared.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ito, R., Ishii, H., Oshima, S. et al. Outcomes after drug-coated balloon interventions for de novo coronary lesions in the patients on chronic hemodialysis. Heart Vessels 36, 1646–1652 (2021). https://doi.org/10.1007/s00380-021-01858-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00380-021-01858-3

Keywords

Search

Navigation