| Coronary artery bypass surgery versus percutaneous coronary artery intervention in patients on chronic hemodialysis: does a drug-eluting stent have an impact on clinical outcome? | |
| | |
MedLine Citation:
|
PMID: 19438773 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Coronary revascularization methods continue to be refined, and the emergence of the drug-eluting stent (DES) has especially changed clinical practice related to ischemic heart disease. For chronic hemodialysis (HD) patients, however, the impact of DES on clinical outcome is yet to be determined. Forty-six consecutive chronic HD patients who underwent myocardial revascularization in our institute were retrospectively reviewed. Twenty-eight patients underwent coronary artery bypass surgery (CABG) and 18 patients underwent percutaneous coronary artery intervention (PCI). Patient characteristics were similar between the two groups. In the CABG group, bilateral internal thoracic artery (ITA) bypass grafting was performed in 27 patients and off-pump CABG was performed in 20 patients. In the PCI group, a DES was used in 12 patients. The number of coronary vessels treated per patient was higher in the CABG group (CABG: 4.25 +/- 1.32 vs. PCI: 1.44 +/- 0.78; p < 0.001). Two-year survival rates were similar between the two groups (CABG: 94.1% vs. PCI: 73.9%; p = 0.41), but major adverse cardiac event-free survival (CABG: 85.9% vs. PCI: 37.1%; p = 0.001) and angina-free survival (CABG: 84.9% vs. PCI: 28.9%; p < 0.001) rates were significantly higher in the CABG group. The one-year patency rate for the CABG grafts was 93.3% (left ITA: 100%, right ITA: 84.6%, sapenous vein: 90.9%, gastro-epiploic artery: 100%), and six-month restenosis rate for PCI was 57.1% (balloon angio-plasty: 75%, bare metal stent 40%, DES: 58.3%). Even in the era of DES, clinical results favored CABG. The difference in clinical results is due to the sustainability of successful revascularization. |
| | |
Authors:
|
Susumu Manabe; Tomoki Shimokawa; Toshihiro Fukui; Ken-u Fumimoto; Naomi Ozawa; Hiroshi Seki; Shuichiro Takanashi |
Related Documents
:
|
18252973 - Bifurcation coronary artery disease: current techniques and future directions (part 1). 11858773 - Restenosis: intracoronary brachytherapy. 7631933 - Peripheral vascular complications of aortic dissection. |
Publication Detail:
|
Type: Comparative Study; Journal Article |
Journal Detail:
|
Title: Journal of cardiac surgery Volume: 24 ISSN: 1540-8191 ISO Abbreviation: J Card Surg Publication Date: 2009 May-Jun |
Date Detail:
|
Created Date: 2009-05-14 Completed Date: 2009-08-18 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 234-9 Citation Subset: IM |
Affiliation:
|
Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo, Japan. s-manabe@fb3.so-net.ne.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angioplasty, Transluminal, Percutaneous Coronary
/
methods* Coronary Artery Bypass / methods* Coronary Artery Disease / complications, mortality, therapy* Disease-Free Survival Drug-Eluting Stents* Female Follow-Up Studies Humans Japan / epidemiology Kidney Failure, Chronic / complications, mortality, therapy* Male Middle Aged Renal Dialysis / methods* Retrospective Studies Survival Rate Time Factors Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Evaluation of the chondral modeling theory using fe-simulation and numeric shape optimization.
Next Document: Elective hypothermic circulatory arrest to address aortic pathology is safe for the elderly.