The relationship between chronic kidney disease and “complex” percutaneous coronary intervention: Uncovering the details

Key Points It remains unclear whether the complexity level of coronary interventions affects cardiovascular outcomes in patients with chronic kidney disease (CKD). This study showed that “complex” percutaneous coronary intervention (PCI) is associated with a greater risk of adverse cardiovascular events than standard PCI in both patients with or without CKD. However, the complexity of PCI appeared to have a greater effect on all‐cause mortality and bleeding in patients with CKD than in those without CKD. The data presented confirm the predicted effect of CKD on outcomes after complex PCI. However, the similar effect of complex PCI observed in patients with or without CKD suggests that some patients with CKD have an acceptable risk profile to undergo complex intervention. The reported findings should be interpreted with caution; making a patient‐specific decision before PCI is key in this patient population.