Coronary angioplasty in patients with kidney failure is associated with an increased occurrence of events. This study compared the efficacy of preventing clinical restenosis using an everolimus-eluting stent versus a conventional stent, both implanted in the same patient with lesions in more than one vessel and suffering from kidney failure. The primary endpoint was target vessel revascularization guided by ischemia at the 12-month follow-up. 510 lesions were randomized (215 patients randomized per vessel). 43.8% of patients were diabetic and 41.7% had 3-vessel disease. The occurrence of the primary endpoint was significantly lower in vessels treated with the everolimus-eluting stent (2.7% versus 11.4%, p<0.01) and was independent of the degree of kidney failure. In the multivariate analysis, the only independent predictors of events were the conventional stent and vessel diameter. 

Conclusion: This study demonstrates the benefit of preventing clinical restenosis using a second-generation DES in patients with kidney failure. This effect of the drug-eluting stent was independent of the degree of kidney failure.

Fabrizio Tomai, MD, FACC, FESC.
2013-05-23

Original title: Randomised comparison of Xience and Multi-link Vision coronary stentsin the same multivessel patient with chronic kidney disease (renal-DES) study.