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Abstract
objectives: This study sought to examine the immediate and short term outcome (6 months) of Percutaneous coronary interventions (PCIs) in patients with advanced chronic kidney disease (CKD). Background : PCI 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) < 30 ml/min). methods: 642 consecutive patients underwent PCIs. Patients were classified according to creatinine clearance into 3 groups. group 1, Cr Cl >70, group 2, CrCl <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. Results : Although immediate angiograhic 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<0.00002. conclusions : PCI for patient with advanced CKD carries a very high risk. It should be done on individual basis. Outcome is expected to be poor and short term benefit is expected to be limited