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Long-term outcome of hemodialysis patients after deferral revascularization based on functional flow reverse

Session Poster session 1

Speaker Takashi Nagasaka

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : T Nagasaka (Maebashi,JP), R Funada (Maebashi,JP), A Umeyama (Maebashi,JP), M Sato (Maebashi,JP), N Takama (Maebashi,JP), M Kurabayashi (Maebashi,JP)

Authors:
T. Nagasaka1 , R. Funada1 , A. Umeyama1 , M. Sato1 , N. Takama1 , M. Kurabayashi1 , 1Gunma University School of Medicine, Department of Cardiology - Maebashi - Japan ,

Citation:
European Heart Journal ( 2017 ) 38 ( Supplement ), 192

Background: Functional flow reverse (FFR) is the useful device to assess the functional significance of intermediate coronary stenosis. Recent studies reported that outcome after deferral of percutaneous coronary intervention (PCI) of an intermediate coronary stenosis based on FFR was excellent. However, few studies have focused on hemodialysis (HD) patients.

Purpose: Our aim in this study is to assess the long-term outcome of HD patients after deferral revascularization based on FFR.

Methods: A total of 125 consecutive patients in whom PCI was deferred were included between May 2014 and December 2016. Based on deferral criteria (FFR>0.80), we assess the differences with respect to cardiac death, myocardial infarction (MI) and target lesion failure (TLF) between HD (n=46) and non-HD group (n=79) during follow-up (mean 26.9±7.3 months).

Results: There was no significant difference in male sex, age, left ventricular ejection fraction (LVEF), mean FFR (HD group; 0.85±0.09 vs non-HD group; 0.86±0.10, p=0.62), hypertension, dyslipidemia, smoking, family history and medication at baseline between two groups. However, HD group had significantly higher rate of diabetes mellitus patients than non-HD group (68.8% vs. 43.7%, p=0.029). No significant difference was shown with respect to cardiac death and MI. Survival rate free showed that TLF was significantly lower in HD group than in non-HD group (70.6% vs 87.3%, log-rank p=0.037) (Figure 1).

Conclusion: This study revealed the prognosis of HD patients with deferred lesions based on FFR was worse than non-HD patients. The rate of atherosclerotic plaque progression could be associated with hemodialysis. Therefore, it is important to observe carefully for HD patients with intermediate coronary stenosis.

Figure1

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