Long-term patient and kidney survival after coronary artery bypass grafting, percutaneous coronary intervention, or medical therapy for patients with chronic kidney disease: a propensity-matched cohort study

Background Revascularization in patients with chronic kidney disease (CKD) and coronary artery disease (CAD) is often deferred because of concern over progression of renal failure. Hypothesis Revascularization with either coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) leads to progression of renal failure, but improves survival compared with medical therapy in patients with CKD. Patients and methods Linkages between the British Columbia Cardiac Registry and the British Columbia Renal Registry of patients with established CAD and CKD who underwent CABG, PCI, or were treated medically were propensity matched. Overall patient survival was analyzed using a Cox proportional hazard model. Primary renal outcomes, defined as patients requiring long-term dialysis or progressive loss in kidney function, were analyzed using a competing risk approach. Results On the basis of the matched cohort, the risk of renal outcome in the first three months was the highest in the CABG group, but comparable between the PCI and the medical group (estimated probability at 3 months: 12.7% for CABG, 5.4% for PCI, 4.4% for medical; P
Source: Coronary Artery Disease - Category: Cardiology Tags: Original Research Source Type: research