Comparing Revascularization Strategies in CAD Patients with Chronic Kidney Disease

A propensity-matched comparison demonstrates surprising benefits for percutaneous coronary intervention, although coronary artery bypass grafting might be better for patients on dialysis.

Current guidelines, based on observational studies with first-generation stents, recommend coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) in patients with both chronic kidney disease (CKD) and multivessel coronary artery disease (CAD). In this industry-funded comparison using New York State Reporting System data, investigators compared 2960 patients with multivessel CAD (≥2 major epicardial vessels) and estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m² who received PCI with everolimus-eluting stents to 2960 propensity-score-matched patients undergoing CABG.

At baseline, 48% of the study population had diabetes, and 8% were on dialysis. At 30 days, PCI was associated with a lower risk for dea…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)