Limited value and prohibitive risk of percutaneous coronary interventions in patients with advanced chronic kidney disease

AbstractObjectivesThis study sought to examine the immediate and short term outcome (6months) of percutaneous coronary interventions (PCIs) in patients with advanced chronic kidney disease (CKD).BackgroundPCI is established as a safe and effective option to treat patients with coronary artery disease. Difficulties and complications are known to be higher during PCI in patients with chronic kidney disease (CKD). Few data exist on the immediate and short term outcome of PCI in patients with advanced chronic kidney disease (creatinine clearance (Cr Cl) <30ml/min).Methods642 consecutive patients underwent PCIs. Patients were classified according to creatinine clearance into 3 groups. Group 1, Cr Cl >70, Group 2, Cr Cl <70 and >30, Group 3, Cr Cl <30. Group 1 included 332 (51.7%), group 2 included 292 patients (45.5%) and group 3 included 18 patients (2.8%). Immediate and short term follow-up (6months) was done for death, myocardial infarction, bleeding, TIA or cerebro-vascular stroke, contrast induced nephropathy (CIN) and repeated revascularization.ResultsAlthough immediate angiographic and procedural success was high (>93%) in all groups, as compared to patients in group 1 and 2, patients in group 3 had higher in-hospital morbidity (61% vs 0.9% and 8% for groups 3, 1 and 2 respectively P<0.0001, and mortality (5.6% vs 0.6% and 0.6% for groups 3, 1 and 2 respectively P<0.001) and short term, mortality was 28% vs 1.8% and 5.8% for in groups 3, 1 and 2 respectively, p