Everolimus-Eluting Coronary Stents for Patients With Chronic Kidney Disease: What Explains the Magic?

R andomized, controlled trials (RCTs) comparing percutaneous coronary intervention (PCI) with coronary artery bypass graft (CABG) surgery for multivessel coronary artery disease (CAD) have routinely excluded patients with chronic kidney disease (CKD), so decisions about revascularization in this population depend on other sources of evidence (1). Several observational studies have reported that patients with CKD or end-stage renal disease requiring hemodialysis had higher mortality rates after PCI than after CABG for multivessel CAD (2,3), resulting in clinical guidelines favoring surgical therapy over PCI for this population of patients (4).