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Kobayashi N, Muramatsu T, Tsukahara R, Ito Y, Ishimori H, Hirano K, Nakano M, Yamawaki M, Araki M, Takimura H, Sakamoto Y. Influence of hemodialysis duration on mid-term clinical outcomes in hemodialysis patients with coronary artery disease after drug-eluting stent implantation. Heart Vessels 2014; 31:330-40. [PMID: 25523891 DOI: 10.1007/s00380-014-0615-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Accepted: 12/12/2014] [Indexed: 11/29/2022]
Abstract
Accelerated atherosclerosis in prolonged maintenance hemodialysis (HD) has been recognized; however, whether HD duration is associated with poor clinical outcome in HD patients with coronary artery disease (CAD) after drug-eluting stent (DES) implantation is unknown. We evaluated the impact of HD duration on clinical outcomes in HD patients with CAD after DES implantation. Between April 2007 and December 2012, 168 angina pectoris patients (320 de novo lesions) on HD were treated with DES. Major adverse cardiovascular events (MACE) and target lesion revascularization (TLR) were investigated at 3 years according to the HD duration (≤ 3 years, 83 patients; >3 years, 85 patients). The incidence of MACE was significantly higher in the long HD duration group (25.3 vs. 50.6 %; P = 0.001). Especially, sudden cardiac death (SCD) was significantly higher in the long HD duration group (3.6 vs. 16.5 %; P = 0.006). On the other hand, the rates of TLR were similar between the two groups (12.0 vs. 14.1 %; P = 0.69). Cox's proportional hazard analysis revealed that HD duration (HR 1.08 per year, 95 % CI 1.03-1.13, P = 0.002), β-blocker use (0.28, 0.17-0.46, P < 0.001), and diabetes mellitus (2.10, 1.23-3.56, P = 0.007) were independent predictors of MACE. Longer HD duration did not affect TLR; however, SCD was significantly higher in the long HD duration group.
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Affiliation(s)
- Norihiro Kobayashi
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan.
| | - Toshiya Muramatsu
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Reiko Tsukahara
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Yoshiaki Ito
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Hiroshi Ishimori
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Keisuke Hirano
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Masatsugu Nakano
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Masahiro Yamawaki
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Motoharu Araki
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Hideyuki Takimura
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
| | - Yasunari Sakamoto
- Department of Cardiology, Saiseikai Yokohama-city Eastern Hospital, 3-6-1 Shimosueyoshi, Tsurumi-ku, Yokohama, Kanagawa, 230-8765, Japan
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Yaku H, Doi K, Okawa K. Off-pump coronary artery bypass grafting revisited: experience and evidence from Japan. Ann Thorac Cardiovasc Surg 2013; 19:83-94. [PMID: 23575000 DOI: 10.5761/atcs.ra.12.02113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Off-pump coronary artery bypass grafting (OPCAB) is performed in about 65% of patients who require surgical coronary revascularization, and has become the standard procedure in coronary artery bypass grafting (CABG) in Japan. As a background of the high rate of OPCAB, many clinical and experimental studies have been performed and reported in Japan. In this review, several factors associated with OPCAB are discussed based on relevant and important clinical studies published in Japan in the English language.
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Affiliation(s)
- Hitoshi Yaku
- Department of Cardiovascular Surgery, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
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Natsuaki M, Furukawa Y, Morimoto T, Nakagawa Y, Akao M, Ono K, Shioi T, Shizuta S, Sakata R, Okabayashi H, Nishiwaki N, Komiya T, Suwa S, Kimura T. Impact of Diabetes on Cardiovascular Outcomes in Hemodialysis Patients Undergoing Coronary Revascularization. Circ J 2011; 75:1616-25. [DOI: 10.1253/circj.cj-10-1235] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Masahiro Natsuaki
- Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University
| | - Yutaka Furukawa
- Department of Cardiovascular Medicine, Kobe City Medical Center General Hospital
| | - Takeshi Morimoto
- Center for Medical Education, Graduate School of Medicine, Kyoto University
| | | | | | - Koh Ono
- Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University
| | - Tetsuo Shioi
- Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University
| | - Satoshi Shizuta
- Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University
| | - Ryuzo Sakata
- Department of Cardiovascular Surgery, Graduate School of Medicine, Kyoto University
| | | | - Noboru Nishiwaki
- Department of Cardiovascular Surgery, Nara Hospital Kinki University Faculty of Medicine
| | - Tatsuhiko Komiya
- Department of Cardiovascular Surgery, Kurashiki Central Hospital
| | - Satoru Suwa
- Division of Cardiology, Juntendo University Shizuoka Hospital
| | - Takeshi Kimura
- Department of Cardiovascular of Medicine, Graduate School of Medicine, Kyoto University
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Yoo YC, Youn YN, Shim JK, Kim JC, Kim NY, Kwak YL. Effects of Renin-Angiotensin System Inhibitors on the Occurrence of Acute Kidney Injury Following Off-Pump Coronary Artery Bypass Grafting. Circ J 2010; 74:1852-8. [DOI: 10.1253/circj.cj-10-0261] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Young Chul Yoo
- Department of Anesthesiology and Pain Medicine, Yonsei University Health System
| | - Young-Nam Youn
- Division of Cardiovascular Surgery, Yonsei University Health System
| | - Jae Kwang Shim
- Department of Anesthesiology and Pain Medicine, Yonsei University Health System
- Anesthesia and Pain Research Institute, Yonsei University Health System
| | - Jong Chan Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University Health System
| | - Na Young Kim
- Department of Anesthesiology and Pain Medicine, Yonsei University Health System
| | - Young Lan Kwak
- Department of Anesthesiology and Pain Medicine, Yonsei University Health System
- Anesthesia and Pain Research Institute, Yonsei University Health System
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Kinoshita T, Asai T, Murakami Y, Suzuki T, Kambara A, Matsubayashi K. Preoperative Renal Dysfunction and Mortality After Off-Pump Coronary Artery Bypass Grafting in Japanese. Circ J 2010; 74:1866-72. [DOI: 10.1253/circj.cj-10-0312] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Takeshi Kinoshita
- Division of Cardiovascular Surgery, Shiga University of Medical Science
| | - Tohru Asai
- Division of Cardiovascular Surgery, Shiga University of Medical Science
| | | | - Tomoaki Suzuki
- Division of Cardiovascular Surgery, Shiga University of Medical Science
| | - Atsushi Kambara
- Division of Cardiovascular Surgery, Shiga University of Medical Science
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