One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry
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Author(s)
Scholz, Sean S.
Lauder, Lucas
Ewen, Sebastian
Kulenthiran, Saarraaken
Marx, Nikolaus
Sakhov, Orazbek
Kauer, Floris
Witkowski, Adam
Vaglimigli, Marco
Wijns, William
Date Issued
December 2019
Journal
Clinical Research in Cardiology
Publisher
Springer Science and Business Media LLC
Citation
Scholz, Sean S. et al. "One-year clinical outcomes in patients with renal insufficiency after contemporary PCI: data from a multicenter registry." Clinical Research in Cardiology 109, 7 (December 2019): 845–856 © 2019 Springer Nature
Version
Final published version
Abstract
Abstract
Background
Chronic kidney disease (CKD) is highly prevalent in patients with coronary artery disease (CAD).
Objective
The outcome following revascularization using contemporary technologies (new-generation abluminal sirolimus-eluting stents with thin struts) in patients with CKD (i.e., glomerular filtration rate of < 60 mL/min/1.73m2) and in patients with hemodialysis (HD) is unknown.
Methods
e-Ultimaster is a prospective, single-arm, multi-center registry with clinical follow-up at 3 months and 1 year.
Results
A total of 19,475 patients were enrolled, including 1466 patients with CKD, with 167 undergoing HD. Patients with CKD had a higher prevalence of overall comorbidities, multiple/small vessel disease (≤ 2.75 mm), bifurcation lesions, and more often left main artery treatments (all p < 0.0001) when compared with patients with normal renal function (reference). CKD patients had a higher risk of target lesion failure (unadjusted OR, 2.51 [95% CI 2.04–3.08]), target vessel failure (OR, 2.44 [95% CI 2.01–2.96]), patient-oriented composite end point (OR, 2.19 [95% CI 1.87–2.56]), and major adverse cardiovascular events (OR, 2.34 [95% CI 1.93–2.83, p for all < 0.0001]) as reference. The rates of target lesion revascularization (OR, 1.17 [95% CI 0.79–1.73], p = 0.44) were not different. Bleeding complications were more frequently observed in CKD than in the reference (all p < 0.0001).
Conclusion
In this worldwide registry, CKD patients presented with more comorbidities and more complex lesions when compared with the reference population. They experienced higher rate of adverse events at 1-year follow-up.
Graphic abstract
One-year summary outcomes of contemporary PCI in renal insufficiency. CKD chronic kidney disease, POCE patient oriented composite endpoint, MACE major adverse cardiovascular events, TLF target lesion failure, TLR target lesion revascularization, ST stent thrombosis
MIT Department
Massachusetts Institute of Technology. Institute for Medical Engineering & Science
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DOI of Published Version
https://doi.org/10.1007/s00392-019-01575-y
