Clinical effect of percutaneous coronary intervention in maintenance hemodialysis patients combined with non-ST-segment elevation acute coronary syndrome / 中国医师进修杂志

ABSTRACT

Objective:To explore the safety and efficiency of percutaneous coronary intervention (PCI) in maintenance hemodialysis patients combined with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).Methods:The clinical data of 52 maintenance hemodialysis patients combined with NSTE-ACS from January 2010 to January 2015 in Dalian Central Hospital were retrospectively analyzed. Among of them, 25 patients were treated with common drugs (control group), and 27 patients were treated with common drugs combined with PCI (PCI group). The major adverse cardiac events (MACE) duration of hospital stay were record, including hemorrhage, malignant arrhythmia, new heart failure or aggravation, stroke and all-cause death. The dialysis complications within 1 month after treatment were recorded, including hypotension, arrhythmia, heart failure and angina pectoris. The patients were followed up for 12 months, the MACE 1, 6 and 12 months after treatment were recorded, including angina pectoris, heart failure and cardiac death.Results:Duration of hospital stay, the incidences of malignant arrhythmia and new heart failure or aggravation in PCI group were significantly lower than those in control group: 18.5% (5/27) vs. 44.0% (11/25) and 7.4% (2/27) vs. 32.0% (8/25), and there were statistical differences ( P<0.05); there were no statistical difference in the incidences of hemorrhage, stroke and all-cause death between the two groups ( P>0.05). The incidences of dialysis complications such as hypotension, arrhythmia, heart failure and angina pectoris within 1 month after treatment in PCI group were significantly lower than those in control group: 24.0% (6/25) vs. 56.5% (13/23), 16.0% (4/25) vs. 43.5% (10/23), 12.0% (3/25) vs. 47.8% (11/23) and 24.0% (6/25) vs. 52.2% (12/23), and there were statistical differences ( P<0.05 or <0.01). The follow-up results showed that the incidences of angina pectoris and heart failure 1, 6 and 12 months after treatment in PCI group were significantly lower than those in control group, angina pectoris: 28.0% (7/25) vs. 65.2% (15/23), 29.2% (7/24) vs. 76.2% (16/21) and 43.5% (10/23) vs. 17/17, heart failure: 16.0% (4/25) vs. 43.5% (10/23), 8.3% (2/24) vs. 33.3% (7/21) and 21.7% (5/23) vs. 10/17, and there were statistical differences ( P<0.05 or <0.01); there was no statistical difference in the incidence of cardiac death 1 and 6 months after treatment between two groups ( P>0.05), the incidence of cardiogenic death 12 months after treatment in PCI group was significantly lower than that in control group: 8.6% (2/23) vs. 9/17, and there was statistical difference ( P<0.01). Conclusions:PCI is safe and effective for maintenance hemodialysis patients combined with NSTE-ACS.