| Early and Late Outcomes of Coronary Artery Bypass Surgery Versus Percutaneous Coronary Intervention with Drug-Eluting Stents for Dialysis Patients. | |
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MedLine Citation:
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PMID: 22500723 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Abstract Background: Advances in percutaneous coronary intervention (PCI) using drug-eluting stents (DES) have impacted clinical practice. However, the efficacy of DES for dialysis patients still remains controversial. This study compares the early and long-term clinical outcomes of coronary artery bypass grafting (CABG) and PCI with DES in dialysis patients. Methods: A retrospective review was performed in 125 dialysis patients treated between 2004 and 2007. Fifty-eight patients underwent CABG and 67 underwent PCI with DES. The overall death, cardiac death, and cardiac-related event rates were analyzed using the Kaplan-Meier method. For the risk-adjusted comparisons, multivariable logistic and Cox regression analyses were used. Results: The preoperative characteristics of the patients were similar except for the ejection fraction (p = 0.002) and the number of diseased vessels (p < 0.001). The 30-day mortality was 0 in both groups. The overall survival rates at one, three, and five years were 84.2%, 64.7%, and 56.2% in CABG group and 88.2%, 75.5%, and 61.7% in DES group, respectively (p = 0.202). The rates of freedom from cardiac-related events at one, three, and five years were 76.6%, 68.1%, and 48.6%, and 63.0%, 31.4%, and 0% in CABG and DES groups (p < 0.001), respectively, including seven (10%) late thromboses in the DES group. Although the risk-adjusted analysis showed no significant difference for overall and cardiac death rates, the rates of cardiac-related events and graft/stent failure were significantly higher in the DES group. Conclusions: CABG is superior for revascularization in dialysis patients compared with PCI using DES in terms of freedom from cardiac-related events. (J Card Surg 2012; ** :1-7). |
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Authors:
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Sachie Terazawa; Kazuyoshi Tajima; Yoshiyuki Takami; Keisuke Tanaka; Noritaka Okada; Akihiko Usui; Yuichi Ueda |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-4-16 |
Journal Detail:
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Title: Journal of cardiac surgery Volume: - ISSN: 1540-8191 ISO Abbreviation: - Publication Date: 2012 Apr |
Date Detail:
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Created Date: 2012-4-16 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 Wiley Periodicals, Inc. |
Affiliation:
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Department of Cardiothoracic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan Department of Cardiovascular Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Aichi, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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