title: Randomized Comparison of Xience V and Multi-Link Vision Coronary Stents in the Same Multivessel Patient With Chronic Kidney Disease (RENAL-DES) Study.
abstract: BACKGROUND
  Percutaneous coronary interventions in patients with chronic kidney disease have shown suboptimal results. Drug-eluting stents (DES) might reduce the rate of target vessel revascularization in comparison with bare-metal stents (BMS) in patients with chronic kidney disease. However, given the multiple concomitant individual variables present in such patients, the comparison of neointimal growth after percutaneous coronary intervention is complex and difficult to assess.
  
  
  RESULTS
  Randomized Comparison of Xience V and Multi-Link Vision Coronary Stents in the Same Multivessel Patient with Chronic Kidney Disease (RENAL-DES) was a prospective, randomized, multicenter study to directly compare the efficacy in the prevention of clinical restenosis of everolimus-eluting stent (Xience V) and BMS with an identical design (Multi-Link Vision), both implanted in the same patient with multivessel coronary artery disease and chronic kidney disease (estimated glomerular filtration rate <60 mL/min). The primary end point of the study was the ischemia-driven target vessel revascularization as detected with myocardial scintigraphy at 12 months. In 215 patients, 512 coronary vessels were successfully treated with the randomly assigned DES (n=257) or BMS (n=255). At 1 year, the rate of ischemia-driven target vessel revascularization for DES and BMS groups was 2.7% (95% confidence interval, 1.1%-5.6%) and 11.4% (95% confidence interval, 7.8% to 16%), respectively, P<0.001. For the multivariate analysis, independent predictors of the ischemia-driven target vessel revascularization were BMS implantation (odds ratio, 4.95; 95% confidence interval, 2.1-11.6; P<0.001) and vessel size (odds ratio, 0.32; 95% confidence interval, 0.1-0.7; P=0.006).
  
  
  CONCLUSIONS
  This is the first randomized trial showing a reduction of clinical restenosis with a new-generation DES in comparison with a BMS of equal design, in patients who have chronic kidney disease with multivessel coronary artery disease.
  
  
  BACKGROUND
  http://clinicaltrials.gov. Unique identifier: NCT00818792.
authors.affiliation: Department of Cardiovascular Sciences, European Hospital, Rome, Italy (F.T., L.D.L., A.P., A.S.G., L.W.); Division of Cardiology of the Department of Medicine, University of Verona, Verona, Italy (F.R., M.P., C.V.); Institute of Cardiology, University Magna Grecia, Catanzaro, Italy (C.S.); Department of Cardiology, Vannini Hospital, Rome, Italy (I.P.); Institute of Cardiology, Cattolica University, Rome, Italy (C.T.); and Division of Nuclear Medicine, Madonna della Fiducia Clinic, Rome, Italy (F.N.).
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Tomai
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Leonardo
authors.initials: L
authors.lastname: De Luca
authors.forename: Alessandro
authors.initials: A
authors.lastname: Petrolini
authors.forename: Anna S
authors.initials: AS
authors.lastname: Ghini
authors.forename: Luca
authors.initials: L
authors.lastname: Weltert
authors.forename: Carmen
authors.initials: C
authors.lastname: Spaccarotella
authors.forename: Igino
authors.initials: I
authors.lastname: Proietti
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.forename: Francesco
authors.initials: F
authors.lastname: Nudi
authors.forename: Michele
authors.initials: M
authors.lastname: Pighi
authors.forename: Corrado
authors.initials: C
authors.lastname: Vassanelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000628:therapy*; D054855:Drug-Eluting Stents; D023381:Endpoint Determination; D000068338:Everolimus; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation* / Q000379:methods*; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D020123:Sirolimus / Q000031:analogs & derivatives; D015607:Stents; D016896:Treatment Outcome
chemical_list: D000068338:Everolimus; D020123:Sirolimus
keywords: drug-eluting stents; percutaneous coronary intervention; renal insufficiency; renal insufficiency, chronic