Clinical Outcomes Among Percutaneous Coronary Intervention Patients With Or Without Chronic Kidney Disease Using Drug-Eluting Stents

Objectives: This study sought to evaluate ischemic and bleeding outcomes in patients with or without chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES).Background: Previous studies have shown that CKD is associated with poor outcomes after PCI. However, these studies were largely conducted before the introduction of DES and aggressive antithrombotic therapy or were performed in the setting of randomized trials. With data from a contemporary registry, we evaluated the influence of CKD on major cardiovascular events and bleeding complications in unselected "real-world" patients undergoing PCI.Methods: Data from 91 patients enrolled in the Cardiovascular Diease Department of Yongzhou People's Hospital between July 2007 and September 2009 were analyzed. Patients were stratified into 2 groups: creatinine clearance (CrCl) >75,≤75 ml/min.Results: During the index hospital stay, there was a significant increase in bleeding complications with decreasing CrCl (p = 0.0157 for trend). Lower CrCl was also associated with more frequent death or myocardial infarction (MI) during the initial hospital stay (p = 0.0257) and at 1 year (p = 0.0091). These findings were confirmed in multivariate analyses that adjusted for baseline differences in demographic, clinical, and angiographic factors. Conclusions: Renal function is an independent and powerful predictor of bleeding and ischemic complications in the era of DES and contemporary antithrombotic therapy in patients undergoing PCI.