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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

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Mode of Coronary Revascularization and Short term Clinical Outcomes in Patients with Chronic Kidney Disease

Ashique Ali Khoso1, Khawar Abbas Kazmi2, Saqiba Tahir3

  • 1Ashique Ali Khoso, Senior Instructor, Section of Cardiology, Department of Medicine, Aga Khan University, Karachi, Pakistan.

Pakistan Journal of Medical Sciences
|February 13, 2015
PubMed

Insights

Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) offer similar short-term outcomes for chronic kidney disease (CKD) patients. PCI is a viable, less invasive alternative for moderate to severe CKD.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Coronary revascularization via PCI or CABG in chronic kidney disease (CKD) patients presents a complex clinical decision.
  • The comparative risks and benefits of PCI versus CABG in CKD populations remain a subject of ongoing debate.

Purpose of the Study:

  • To determine which revascularization strategy, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery, is associated with lower risks of mortality and morbidity in patients with chronic kidney disease (CKD).

Main Methods:

  • A cross-sectional study involving 159 CKD patients undergoing coronary revascularization (PCI or CABG) at a single center.
  • The primary outcome assessed was the in-hospital composite of death, myocardial infarction (MI), or stroke.
  • Analysis focused on comparing clinical outcomes between PCI and CABG groups, stratified by CKD severity.

Main Results:

  • Of 159 CKD patients, 85 (53.5%) underwent PCI and 74 (46.5%) underwent CABG.
  • Patients with moderate to severe CKD were more likely to receive PCI, while those with mild to moderate CKD favored CABG.
  • No significant difference in short-term clinical outcomes (death, MI, stroke) was observed between PCI and CABG in either CKD severity group.

Conclusions:

  • Short-term clinical outcomes are comparable for patients with moderate to severe CKD undergoing either PCI or CABG.
  • Percutaneous coronary intervention (PCI) emerges as an acceptable and less invasive alternative to coronary artery bypass graft (CABG) surgery for this patient cohort.
Abstract

Keywords:
Chronic kidney diseaseCoronary artery bypass graftCoronary revascularizationCreatinine clearancePercutaneous coronary intervention

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