Coronary angioplasty in haemodialysis patients.

The results of balloon coronary angioplasty are very disappointing In haemo dialysis patients because of the high restenosis rate. On the other hand, t he use of stents in this population had not previously been assessed. This retrospective study compared 63 coronary patients on haemodialysis wit h a reference group of 63 paired patients with respect to gender, age, and the necessity or not of stent implantation. There was a higher frequency of hypertension (79 vs 39%) and of hypertriglyceridaema (22 vs 8%) in the hae modialysis group than in the controls. However, there was no significant di fference with respect to primary success rate of angioplasty (92 and 89% re spectively), nor to the development of early cardiovascular complications ( 4% and 1.9% respectively). After a two-year follow-up, there was no signifi cant difference in the restenosis rate in the haemodialysis patients (33%) compared with the controls (25%). Nevertheless, the mortality rate at 2 yea rs was higher in the dialysis group (15%) compared with the reference group (3.5%, p = 0.03). However, this mortality rate was lower than that reporte d in the literature in haemodialysis patients after balloon angioplasty. Therefore, haemodialysis does not increase the risk of restenosis when an o ptimal angiographic result is obtained either by balloon angioplasty or by angioplasty with stenting. Coronary angioplasty is a safe and effective met hod of revascularisation in coronary haemodialysis patients when the lesion s are accessible to stenting.