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Percutaneous coronary intervention compared with coronary artery bypass graft in coronary artery disease patients with chronic kidney disease: a systematic review and meta-analysis.
MedLine Citation:
PMID:  24986458     Owner:  NLM     Status:  Publisher    
Abstract Previous reports of percutaneous coronary intervention versus coronary artery bypass graft outcomes in coronary artery disease patients with chronic kidney disease (CKD) were inconsistent. We evaluated the optimal revascularization strategy for CKD patients. We searched Pub Med, EMBASE, and the Cochrane Central Register of Controlled Trials and scanned the references of relevant articles and reviews. All studies that compared relevant clinical outcomes between percutaneous coronary intervention and coronary artery bypass graft in CKD patients were selected. We defined short-term and long-term all-cause mortality as primary outcome, and long-term incidences of myocardial infarction and revascularization as secondary outcomes. A total of 2235 citations were retrieved, and 31 studies involving 99,054 patients, with 55,383 receiving percutaneous coronary intervention and 43,671 receiving coronary artery bypass graft, were included. In subgroup analyses of dialysis patients receiving percutaneous coronary intervention with stents versus coronary artery bypass graft, CKD patients with multivessel coronary disease, and CKD patients receiving drug-eluting stent versus coronary artery bypass graft, the pooled outcomes revealed that percutaneous coronary intervention possessed lower short-term mortality, but higher late revascularization risk. No significant differences in long-term mortality were observed between the two strategies in these subgroup analyses. In conclusion, in some specific clinical circumstances, CKD patients receiving percutaneous coronary intervention possessed lower short-term all-cause mortality, but higher long-term revascularization risk, than coronary artery bypass graft; long-term all-cause mortality was not different between the two strategies.
Xin Ren; Wei Liu; Yong Peng; Qiao Li; Hua Chai; Zhen-Gang Zhao; Qing-Tao Meng; Chi Chen; Chen Zhang; Xiao-Lin Luo; Mao Chen; De-Jia Huang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-7-2
Journal Detail:
Title:  Renal failure     Volume:  -     ISSN:  1525-6049     ISO Abbreviation:  Ren Fail     Publication Date:  2014 Jul 
Date Detail:
Created Date:  2014-7-2     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8701128     Medline TA:  Ren Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  1-10     Citation Subset:  -    
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