Coronary Artery Bypass Grafting vs. Drug-Eluting Stent Implantation for Multivessel Disease in Patients with Chronic Kidney Disease
Korean Circulation Journal
; : 354-360, 2017.
Artículo
en Inglés
| WPRIM (Pacífico Occidental)
| ID: wpr-76472
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND AND OBJECTIVES:
There is currently a limited amount of data that demonstrate the optimal revascularization strategy for chronic kidney disease (CKD) patients with multivessel coronary artery disease (CAD). We compared the long-term outcomes of percutaneous coronary intervention (PCI) with drug-eluting stents (DES) versus coronary artery bypass graft surgery (CABG) for multivessel CAD in patients with CKD. SUBJECTS ANDMETHODS:
We analyzed 2108 CKD patients (estimated glomerular filtration rate <60 mL/min/1.73 m²) with multivessel CAD that were treated with PCI with DES (n=1165) or CABG (n=943). The primary outcome was a composite of all causes of mortality, myocardial infarction, or stroke. The mean age was 66.9±9.1 years.RESULTS:
Median follow-up duration was 41.4 (interquartile range 12.1-75.5) months. The primary outcome occurred in 307 (26.4%) patients in the PCI group compared with 304 (32.2%) patients in the CABG group (adjusted hazard ratio [HR], 0.941; 95% confidence interval [CI], 0.79–1.12; p=0.493). The two groups exhibited similar rates of all-cause mortality (adjusted HR, 0.91; 95% CI, 0.77–1.09; p=0.295), myocardial infarction (adjusted HR, 1.86; 95% CI, 0.85–4.07; p=0.120) and stroke (3.2% vs. 4.8%; HR, 0.93; 95% CI, 0.57–1.61; p=0.758). However, PCI was associated with significantly increased rates of repeat revascularization (adjusted HR, 4.72; 95% CI, 3.20–6.96; p<0.001).CONCLUSION:
Among patients with CKD and multivessel CAD, PCI with DES when compared with CABG resulted in similar rates of composite outcome of mortality from any cause, MI, or stroke; however, a higher risk of repeat revascularization was observed.
Texto completo:
Disponible
Contexto en salud:
ODS3 - Meta 3.4 Reducir las muertes prematuras por enfermedades no transmisibles
Problema de salud:
Enfermedad Cardiovascular
/
Enfermedad Cerebrovascular
/
Enfermedad Renal Crónica
/
Isquemia Miocárdica
/
Neoplasias del Riñón, Pelvis Renal y Ureteral
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Enfermedad de la Arteria Coronaria
/
Puente de Arteria Coronaria
/
Estudios de Seguimiento
/
Mortalidad
/
Enfermedad Coronaria
/
Vasos Coronarios
/
Trasplantes
/
Accidente Cerebrovascular
/
Insuficiencia Renal
/
Insuficiencia Renal Crónica
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Humanos
Idioma:
Inglés
Revista:
Korean Circulation Journal
Año:
2017
Tipo del documento:
Artículo