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Updated: Dec 30, 2025
A Modified Two Kidney One Clip Mouse Model of Renin Regulation in Renal Artery Stenosis
Published on: October 26, 2020
Coronary revascularization in patients with renal insufficiency: restenosis rate and cardiovascular outcomes
Tobias Pinkau1, Johannes F E Mann, Gjin Ndrepepa
1Deutsches Herzzentrum, Technische Universität, Munich, Germany. pinkau@web.de
Insights
Patients with renal insufficiency undergoing coronary revascularization showed no increased restenosis rates. However, renal insufficiency independently predicted higher rates of death or myocardial infarction.
Area of Science:
- Cardiology
- Nephrology
- Interventional Cardiology
Background:
- Previous studies indicate lower success and event-free survival with coronary angioplasty in renal insufficiency patients.
- Conflicting data exists regarding restenosis rates after coronary angioplasty in this population.
Purpose of the Study:
- To investigate the relationship between renal insufficiency and restenosis after coronary revascularization.
- To assess the impact of renal insufficiency on clinical outcomes following coronary angioplasty or stenting.
Main Methods:
- A cohort of 4,131 coronary artery disease patients treated with angioplasty (23%) or stenting (77%) was analyzed.
- Renal insufficiency was defined as creatinine clearance (CrCl) < 60 mL/min.
- Clinical restenosis (target-lesion revascularization) was the primary endpoint.
Main Results:
- No significant difference in 1-year clinical restenosis rates between patients with and without renal insufficiency (18.8% vs 18.4%).
- Angiographic restenosis rates at 6 months were similar (32.7% vs 29.7%).
- The composite endpoint of death and myocardial infarction was significantly higher in patients with renal insufficiency (8.3% vs 3.2%).
Conclusions:
- Renal insufficiency does not increase the incidence of restenosis following coronary revascularization.
- Renal insufficiency is an independent predictor of adverse outcomes, including death and myocardial infarction.
Background:
Several interventional trials have shown a lower success rate for coronary angioplasty and lower long-term event-free survival in patients with renal insufficiency, and data are conflicting about restenosis after coronary angioplasty.
Methods:
This study included 4,131 consecutive patients with coronary artery disease treated with coronary angioplasty (23%) or stenting (77%). Renal insufficiency is defined as a creatinine clearance (CrCl) less than 60 mL/min (<1.0 mL/s). Of 4,131 patients, 1,412 patients (34.2%) had renal insufficiency and 2,719 patients (65.8%) did not have renal insufficiency. The primary end point of the study is clinical restenosis, defined as the need for target-lesion revascularization.
Results:
There was no difference in clinical restenosis rates between groups after 1 year (18.8% versus 18.4%; P = 0.75). The incidence of angiographic restenosis at the 6-month angiography was 32.7% in the group with renal insufficiency and 29.7% in the group without renal insufficiency ( P = 0.10). The composite end point of death and myocardial infarction was observed more frequently in patients with than without renal insufficiency (8.3% versus 3.2%; P < 0.001). Renal insufficiency was not independently associated with clinical restenosis (for 10-mL/min [0.167-mL/s]) decrease in CrCl, adjusted odds ratio, 1.03; 95% confidence interval [CI], 0.98 to 1.08; P = 0.198), but remained as an independent predictor for death or myocardial infarction (for 10-mL/min [0.167-mL/s] decrease in CrCl, hazard ratio, 1.29; 95% CI, 1.18 to 1.42; P < 0.001).
Conclusion:
Patients with renal insufficiency do not show an increased incidence of restenosis after coronary revascularization.
