Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis
Abstract Percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) undergoing hemodialysis (HD) remains challenging, with limited long-term outcome data. We investigated the long-term prognosis of ACS due to de novo coronary artery lesions and stent thrombosis (ST) in p...
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Nature Portfolio
2025-07-01
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| Series: | Scientific Reports |
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| Online Access: | https://doi.org/10.1038/s41598-025-11968-x |
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| author | Sho Nakao Takayuki Ishihara Katsuki Okada Hirota Kida Takuya Tsujimura Shota Okuno Toshiaki Mano Atsushi Kikuchi Takashi Morita Ryu Shutta Masami Nishino Shumpei Kosugi Yasunori Ueda Yasuhiro Ichibori Yoshiharu Higuchi Daisuke Nakamura Daisaku Nakatani Shungo Hikoso Yohei Sotomi Yasushi Sakata |
| author_facet | Sho Nakao Takayuki Ishihara Katsuki Okada Hirota Kida Takuya Tsujimura Shota Okuno Toshiaki Mano Atsushi Kikuchi Takashi Morita Ryu Shutta Masami Nishino Shumpei Kosugi Yasunori Ueda Yasuhiro Ichibori Yoshiharu Higuchi Daisuke Nakamura Daisaku Nakatani Shungo Hikoso Yohei Sotomi Yasushi Sakata |
| author_sort | Sho Nakao |
| collection | DOAJ |
| description | Abstract Percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) undergoing hemodialysis (HD) remains challenging, with limited long-term outcome data. We investigated the long-term prognosis of ACS due to de novo coronary artery lesions and stent thrombosis (ST) in patients with and without HD. We analyzed 187 patients with ACS from the Osaka Cardiovascular Conference Long ST registry, a retrospective, multicenter registry of definite ST, and 1,856 patients with ACS due to de novo coronary artery lesions at Kansai Rosai Hospital. Patients were grouped by HD status and ACS etiology (de novo- and ST-ACS). The primary outcome was the 6-year incidence of major adverse cardiac events (MACE) defined as a composite of cardiac death, non-fatal myocardial infarction, target vessel revascularization, and subsequent ST. The 6-year MACE rate was highest in ST-ACS with HD, followed by de novo-ACS with HD, ST-ACS without HD, and de novo-ACS without HD (82.1 vs. 62.5 vs. 38.3 vs. 24.2%, respectively, p < 0.001). Multivariate analysis identified HD (hazard ratio [HR]: 2.50, 95% confidence interval [CI]: 1.89–3.32, p < 0.001) and ST-ACS (HR: 1.69, 95% CI: 1.17–2.45, p = 0.006) as independent MACE predictors. The long-term prognoses following ACS are unfavorable in patients on HD, particularly those with ST-ACS. |
| format | Article |
| id | doaj-art-7563cfb5888b445abd5f3fbed3f5197f |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-7563cfb5888b445abd5f3fbed3f5197f2025-08-20T03:45:59ZengNature PortfolioScientific Reports2045-23222025-07-011511910.1038/s41598-025-11968-xLong-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysisSho Nakao0Takayuki Ishihara1Katsuki Okada2Hirota Kida3Takuya Tsujimura4Shota Okuno5Toshiaki Mano6Atsushi Kikuchi7Takashi Morita8Ryu Shutta9Masami Nishino10Shumpei Kosugi11Yasunori Ueda12Yasuhiro Ichibori13Yoshiharu Higuchi14Daisuke Nakamura15Daisaku Nakatani16Shungo Hikoso17Yohei Sotomi18Yasushi Sakata19Cardiovascular Center, Kansai Rosai HospitalCardiovascular Center, Kansai Rosai HospitalDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineCardiovascular Center, Kansai Rosai HospitalDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineCardiovascular Center, Kansai Rosai HospitalDivision of Cardiology, Osaka General Medical CenterDivision of Cardiology, Osaka General Medical CenterDepartment of Cardiology, Rinku General Medical CenterDivision of Cardiology, Osaka Rosai HospitalDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineCardiovascular Division, National Hospital Organization Osaka National HospitalCardiovascular Division, Osaka Police HospitalCardiovascular Division, Osaka Police HospitalDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineDepartment of Cardiovascular Medicine, Nara Medical UniversityDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineDepartment of Cardiovascular Medicine, Osaka University Graduate School of MedicineAbstract Percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS) undergoing hemodialysis (HD) remains challenging, with limited long-term outcome data. We investigated the long-term prognosis of ACS due to de novo coronary artery lesions and stent thrombosis (ST) in patients with and without HD. We analyzed 187 patients with ACS from the Osaka Cardiovascular Conference Long ST registry, a retrospective, multicenter registry of definite ST, and 1,856 patients with ACS due to de novo coronary artery lesions at Kansai Rosai Hospital. Patients were grouped by HD status and ACS etiology (de novo- and ST-ACS). The primary outcome was the 6-year incidence of major adverse cardiac events (MACE) defined as a composite of cardiac death, non-fatal myocardial infarction, target vessel revascularization, and subsequent ST. The 6-year MACE rate was highest in ST-ACS with HD, followed by de novo-ACS with HD, ST-ACS without HD, and de novo-ACS without HD (82.1 vs. 62.5 vs. 38.3 vs. 24.2%, respectively, p < 0.001). Multivariate analysis identified HD (hazard ratio [HR]: 2.50, 95% confidence interval [CI]: 1.89–3.32, p < 0.001) and ST-ACS (HR: 1.69, 95% CI: 1.17–2.45, p = 0.006) as independent MACE predictors. The long-term prognoses following ACS are unfavorable in patients on HD, particularly those with ST-ACS.https://doi.org/10.1038/s41598-025-11968-xAcute coronary syndromeStent thrombosisPercutaneous coronary interventionHemodialysisMajor adverse cardiac eventsPrognosis |
| spellingShingle | Sho Nakao Takayuki Ishihara Katsuki Okada Hirota Kida Takuya Tsujimura Shota Okuno Toshiaki Mano Atsushi Kikuchi Takashi Morita Ryu Shutta Masami Nishino Shumpei Kosugi Yasunori Ueda Yasuhiro Ichibori Yoshiharu Higuchi Daisuke Nakamura Daisaku Nakatani Shungo Hikoso Yohei Sotomi Yasushi Sakata Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis Scientific Reports Acute coronary syndrome Stent thrombosis Percutaneous coronary intervention Hemodialysis Major adverse cardiac events Prognosis |
| title | Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis |
| title_full | Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis |
| title_fullStr | Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis |
| title_full_unstemmed | Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis |
| title_short | Long-term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis |
| title_sort | long term prognosis after acute coronary syndrome due to de novo coronary artery lesions and stent thrombosis in patients on hemodialysis |
| topic | Acute coronary syndrome Stent thrombosis Percutaneous coronary intervention Hemodialysis Major adverse cardiac events Prognosis |
| url | https://doi.org/10.1038/s41598-025-11968-x |
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