Abstract 14638: Stent-type at Percutaneous Coronary Intervention and Long-term Outcomes in Relation to Renal Function: Data From 103.747 Patients in the SCAAR-registry
Objective: To evaluate the risk of hard clinical endpoints of different types of PCI stents in relation to renal function.
Methods: During 2007 and 2013, 103.747 patients enrolled in the Swedish Coronary Angiography & Angioplasty Registry (SCAAR) with a known serum creatinine were treated with PCI using new generation drug eluting stents (n-DES) (n=32.440), old generation drug eluting stents (o-DES) (n=17.363) or bare metal stents (BMS) (n=53.974). Renal function groups were derived from creatinine estimated glomerular filtration rate (eGFR) and expressed in ml/min/1.73 m2. The hazard risk (HR) of the combined endpoint (all-cause mortality or myocardial infarction readmission) was estimated using Cox landmark analyses (≤1 year and >1 year to 3 years). Adjustments were made for year, hospital, extent of coronary artery disease, indication for PCI, use of multiple stents, periprocedural antithrombotic treatment, number of stents, stent dimensions, diabetes, age, gender, risk factors and history of cardiovascular disease.
Results: N-DES was associated with a significantly lower up-to 1 year risk compared to BMS in patients with eGFR >60. These associations were attenuated and not significant in patients with eGFR <60. Adjusted HR comparing o-DES and BMS were not statistically different (≤1 year).
There was no significant difference between n-DES and BMS after 1 year. Compared to BMS, o-DES had significantly higher risks in patients with eGFR ≥60 and in patients with eGFR 30-59 HR was similarly but not significantly elevated.
Conclusion: In this large national registry we found that in patients with normal renal function, n-DES was associated with a lower up to 1-year risk of MI readmission or all-cause mortality, whereas o-DES was associated with a higher risk after 1 year. A similar trend was seen for patients with moderately reduced renal function but not for patients with severely reduced renal function.
Author Disclosures: R. Edfors: None. S. James: None. K. Szummer: None. M. Evans: None. J. Carrero: None. J. Spaak: None. T. Jernberg: None. B. Lagerqvist: None.
- © 2015 by American Heart Association, Inc.