Post-Dialysis Survival Odds Better After CABG vs PCI
US veterans who underwent coronary artery bypass grafting versus percutaneous coronary intervention prior to starting dialysis had a 28% lower risk of death.
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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.
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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.