Objective To observe the efficacy of percutaneous coronary intervention (PCI) in maintenance hemodialysis (MHD) patients with acute coronary syndrome (ACS).
Methods From January 2008 to October 2011, we completed PCI in the 38 MHD patients with ACS in our hospital hemodialysis Division, including 23 males and 15 females, aged 48–74 (mean 64.2 ± 8.2) years old. Protopathy were diabetic nephropathy in 25 cases, hypertensive renal disease in 11 cases, chronic glomerulonephritis in 2 cases; 33 patients were unstable angina, 4 patients were acute non-ST-segment elevation myocardial infarction, and 1 patients was acute ST-segment elevation myocardial infarction. 1 day before PCI, all patients took aspirin 300 mg and clopidogrel 300 mg, then took clopidogrel 75 mg for 1 year and aspirin 100 mg for lifetime. The results of coronary angiography were observed. All cases received 1-year follow-up about the adverse cardiovascular and cerebrovascular events (MACCE).
Results coronary angiography showed all patients with multi-vessel disease, double-vessel disease in 28 patients (73.7%) and three-vessel disease in 10 patients (26.3%). All patients were deployed with drug-eluting stents (DES). Implanted stents diameter were an average of 3.0 ± 0.3mm, and length were an average of 37.7 ± 23.9mm. The angina symptoms disappeared in all patients, while no intraoperative deaths happened. Postoperative angina occurred in 4 cases (10.5%), which relieved after medication adjustment and no one accepted coronary angiography again. NO acute myocardial infarction happened. 1 patient died of acute left ventricular failure, and 1 patient died of cerebral haemorrhage. MACCE occurred in 5.3%.
Conclusions Interventional therapy can improve quality of life and survival in MHD patients with ACS.