Table 4.
Impact of CKD on clinical outcomes after PCI
| CrCl, mL/min | Major Bleeding |
Ischemic Events |
|||||
|---|---|---|---|---|---|---|---|
| End Point(s) and Duration of Follow-Up | Event Rate, % | P Value | End Point(s) and Duration of Follow-Up | Event Rate, % | P Value | ||
| EVENT registry62 (n=4791) | >75 (n=2827, (59%) | In-hospital TIMI major or minor bleeding, major vascular complications, or transfusion/TIMI major bleeding | 3.3/0.2 | <0.0001/0.56 | MI in hospital/at 1 y | 5.7/7.2 | <0.001/0.0007 |
| 50–75 (n=1253, 26%) | 5.0/0.3 | 7.3/9.2 | |||||
| 30–49 (n=571, 12%) | 8.8/1.2 | 8.2/10.7 | |||||
| <30 (n=140, 3% | 14.3/0.0 | 10.0/11.4 | |||||
| ACUITY trial60 (n=13 819) | ≥60 (n=11 350, 80.9) | ACUITY major bleeding at 30 d | 3.6 | <0.0001 | Death resulting from any cause, MI, or unplanned revascularization at ischemia) 30 d/1 y | 7.0/14.4 | <0.0001/0.001 |
| <60 (n=2469, 19.1%) | 9.2 | 10.8/21.6 | |||||
| HORIZON-AMI trial61 (n=3397) | ≥60 (n=2843, 83.7%) | ACUITY major bleeding at 30 d/1 y/2 y | 5.7/6.0/6.7 | <0.0001/<0.0001/ <0.0001 | Death, reinfarction, TVR, or stroke at 30 d/1 y/2 y | 4.3/10.1/19.8 | <0.0001/<0.0001/ <0.0001 |
| 30–60 (n=506, 14.9%) | 12.1/14.3/16.9 | 9.9/18.5/30.0 | |||||
| ≤30 (n=48, 1.4%) | 45.2/45.2/45.2 | 29.2/49.3/70.0 | |||||
| PARIS Registry63 (n=4584) | ≥60 (n=3745, 82.0%) | BARC 3 or 5 bleeding at 2 y | 3.04 | NR | Cardiac death, probable/definite ST, or clinically indicated TVR at 2 y | 10.20 | NR |
| <60 (n=839, 18.0%) | 8.94 | 16.81 | |||||
| ADAPT-DES64 (n=8410) | ≥60 (n=7043, 83.7%) | ACUITY major bleeding at 2 y | 7.5 | <0.001 | Cardiac death, MI, or ischemia-driven TLR at 2 y | 9.9 | <0.001 |
| <60 (n=1367 (16.3%) | 13.9 | 15.3 | |||||
Bleeding definitions are shown in the Appendix in the online-only Data Supplement. ACUITY indicates Acute Catheterization and Urgent Intervention Triage Strategy; ADAPT-DES, Assessment of Dual Antiplatelet Therapy With Drug-Eluting Stents; BARC, Bleeding Academic Research Consortium; CKD, chronic kidney disease; CrCl, creatinine clearance; EVENT, Evaluation of Drug Eluting Stents and Ischemic Events; HORIZON-AMI, Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction; MI, myocardial infarction; NR, not reported; PARIS, patterns of non-adherence to anti-platelet regimens in stented patients; PCI, percutaneous coronary intervention; ST, stent thrombosis; TIMI, Thrombolysis in Myocardial Infarction; TLR, target lesion revascularization; and TVR, target vessel revascularization.