Post-Dialysis Survival Odds Better After CABG vs PCI

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US veterans who underwent coronary artery bypass grafting versus percutaneous coronary intervention prior to starting dialysis had a 28% lower risk of death.
US veterans who underwent coronary artery bypass grafting versus percutaneous coronary intervention prior to starting dialysis had a 28% lower risk of death.
The following article is part of conference coverage from Kidney Week 2017 in New Orleans hosted by the American Society of Nephrology. Renal & Urology News staff will be reporting live on medical studies conducted by nephrologists and other specialists who are tops in their field in acute kidney injury, chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from Kidney Week 2017.

NEW ORLEANS—Coronary artery bypass grafting (CABG) is associated with a lower risk of death after initiation of dialysis compared with percutaneous coronary intervention (PCI), researchers reported at the American Society of Nephrology's Kidney Week 2017 meeting.

Abduzhappar Gaipov, MD, of the University of Tennessee Health Science Center in Memphis, and colleagues compared outcomes from the cardiac procedures in a national cohort of 815 U.S. veterans (mean age 66 years, 99% male, 78% white, 20% black, 84% diabetic) with end-stage renal disease (ESRD) who underwent first CABG (596) or PCI (219) up to 5 years before dialysis initiation.

The all-cause post-dialysis mortality rate after CABG and PCI were 301/1000 patient-years and 436/1000 patient-years, respectively. In multivariate analysis, patients who underwent CABG had a statistically significant 28% lower risk of death from any cause compared with those who underwent PCI, Dr Gaipov's team reported.

It is known that CABG is associated with improved survival compared with PCI among patients with mild-to-moderate CKD and ESRD, but the optimal strategy for coronary artery revasculation in patients with advanced chronic kidney disease who transition to ESRD has been unclear.

Visit Renal & Urology News' conference section for continuous coverage from Kidney Week 2017.


 

Reference 

Gaipov A, Molnar MZ, Potukuchi PK, et al. Pre ESRD Coronary Artery Revascularization and Post ESRD Mortality. Presented in poster format at Kidney Week 2017 in New Orleans (Oct. 31 to Nov. 5). Abstract TH-OR006.

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