Inclusion Criteria:  Consecutive patients undergoing elective and urgent (i.e., non-emergent) PCI Age >18 years eGFR <60 ml/min/1.73 m2 Angina or equivalent and/or documentation of inducible myocardial ischemia Presence of =1 coronary stenosis, evaluated >70% by visual estimation (on a previously performed coronary angiography) or with an FFR =0.80 ability to provide written informed consent  Exclusion Criteria:  Emergent PCI due to either hemodynamic instability, ST-elevation myocardial infarction or sudden cardiac death PCI on chronic total occlusion Prior PCI within 3 weeks Age >90 years Left ventricular ejection fraction <20% Need for mechanical circulatory support Pregnancy Prisoners Non-English speaking patients Inability to provide written informed consent