The Japanese Journal of Clinical Dialysis Vol.30 No.8(2-2)

Theme Diagnosis and treatment for coronary artery disease and valvular heart disease in dialysis patients
Title Clinical outcomes and indications for percutaneous coronary intervention in chronic hemodialysis patients
Publish Date 2014/07
Author Tetsuro Shimura Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital
Author Yoshihiko Seino Cardiovascular Center, Nippon Medical School Chiba Hokusoh Hospital
[ Summary ] Cardiovascular disease is the principal cause of death in hemodialysis (HD) patients, accounting for approximately 40 % of all deaths in these patients. In HD patients with coronary artery disease, percutaneous coronary intervention (PCI) has been demonstrated to be superior to drug therapy in terms of survival. However, coronary artery bypass grafting (CABG) has been shown to be superior in producing revascularization in dialysis patients compared to PCI using DES in terms of freedom from cardiac-related events. Recent research has reported that there are no significant differences in overall survival rates 30 days later, or, one, three, or five years later. Moreover, some research in Japan, has shown PCI's superiority in terms of survival rates observed in long term follow ups. Thus, PCI should be more commonly applied than CABG for patients who have focal stenosis, single coronary artery lesions or who are in high risk general conditions.
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