Background:
Chronic renal disease has been consistently shown to be an independent predictor of poorer long-term clinical outcomes after percutaneous treatment of coronary artery disease, even in DES era. We sought to evaluate the very long-term clinical outcome after DES implantation in this high risk subset in a real world cenario.
Methods and Results:
Between May/2002 and Jan/2007, 2,043 pts treated exclusively with DES were consecutively enrolled in the non-randomized, single-center DESIRE Registry. Recent myocardial infarction (72h), saphenous venous graft and patients with < 6months follow-up were excluded. The remaining pts (n=1500) were divided into 2 groups according to their creatinine clearence: Group I -Clearance ≤ 60 (n= 490) and Group II- clearance >60 (n= 1010). Primary endpoint included combined MACE and stent thrombosis (ST) rate. ST was classified according to ARC definitions. Clinical follow-up was obtained at 1, 3 and 6 months and then annually up to 6 years. Follow-up was achieved in 98% of the eligible cohort (median 3.6 years). Baseline characteristics and late outcomes are displayed in the table
.
Conclusions:
In the DESIRE registry the negative impact of renal dysfunction was considerably minimized by the use of DES, resulting in very low and equivalent rates of myocardial infarction, TLR and ST when compared to patients with preserved renal condition. We especulate that the higher mortality among these very complex pts may reflect the severity of their comorbities.
TCT-166 Predictors of Target Lesion Revascularization After Implantation of Second-Generation Drug-Eluting Stents in Randomized Trials and the “Real-World”: Analysis From Two Large Datasets