title: Short and long term outcome of percutaneous coronary intervention with drug eluting stent and bare metal stent in patients with chronic kidney disease.
abstract: OBJECTIVE
  Coronary artery disease represents the most important cause of mortality and morbidity in chronic kidney disease (CKD). Despite continuous improvements in percutaneous coronary intervention (PCI), CKD is still associated with more adverse events after PCI. We performed a retrospective study to compare bare metal stents (BMS) versus drug eluting stents (DES) in CKD.
  
  
  METHODS
  We included consecutively all patients undergoing PCI at our Centre from July 2002 to December 2005 with CKD, defined as creatinine clearance <60 mL/min. Patients who received only DES were compared to those who received only BMS. The primary end-point was the long-term rate of major adverse cardiac events (MACE, i.e. the composite of death, myocardial infarction and repeat revascularization).
  
  
  RESULTS
  We included a total of 219 patients with CKD out of a total of 2354 patients, with 164 receiving BMS and 55 DES. After a mean follow up of 48 months, the MACE rate was significantly higher in BMS group (71% versus 38%, P<0.001). A similarly increased risk with BMS was found for death (45% versus 17%, P<0.001), whereas the rates for repeat coronary revascularization, myocardial infarction and stent thrombosis were not significantly different. Multivariable analysis showed that BMS vs.. DES implantation was not statistically significant associated with MACE, death, myocardial infarction, rePTCA or stent thrombosis.
  
  
  CONCLUSIONS
  Compared with BMS, use of DES in patients with CKD is safe and effective in reducing adverse outcomes. However, differences found between groups in clinical end-point could be ascribed to selection bias and confounding factors.
authors.affiliation: Division of Cardiology, University of Turin, Turin, Italy. chiara.resmini@gmail.com
authors.forename: C
authors.initials: C
authors.lastname: Resmini
authors.forename: M
authors.initials: M
authors.lastname: Di Cuia
authors.forename: F
authors.initials: F
authors.lastname: Ballocca
authors.forename: F
authors.initials: F
authors.lastname: D'Ascenzo
authors.forename: M
authors.initials: M
authors.lastname: Bollati
authors.forename: C
authors.initials: C
authors.lastname: Moretti
authors.forename: P L
authors.initials: PL
authors.lastname: Omedè
authors.forename: F
authors.initials: F
authors.lastname: Sciuto
authors.forename: F
authors.initials: F
authors.lastname: Gaita
authors.forename: I
authors.initials: I
authors.lastname: Sheiban
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000150:complications* / Q000601:surgery*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention; D011474:Prosthesis Design; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome