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- Title
Meta-analysis of clinical studies comparing coronary artery bypass grafting with percutaneous coronary intervention in patients with end-stage renal disease.
- Authors
Zheng, Hui; Xue, Song; Lian, Feng; Huang, Ri-tai; Hu, Zhen-lei; Wang, Yong-yi
- Abstract
End-stage renal disease (ESRD) patients are at high risk for coronary artery disease (CAD). The optimal revascularization strategy remains unknown. We performed a meta-analysis of retrospective observational trials to compare coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) for ESRD patients with CAD. A search of published reports was conducted to identify clinical studies comparing CABG with PCI in ESRD patients with CAD with a minimal follow-up of 12 months. Sixteen studies included 32 350 ESRD patients with revascularization. Compared with PCI, CABG was associated with a lower risk for late mortality [relative risk (RR) 0.90, 95% confidence interval (CI) 0.87–0.93], myocardial infarction event (RR 0.64, 95% CI: 0.61–0.68), repeat revascularization event (RR 0.22, 95% CI: 0.16–0.31) and cumulative events (RR 0.69, 95% CI: 0.65–0.73), despite having a higher risk for early mortality (RR 1.98, 95% CI: 1.51–2.60). In conclusion, the long-term results of PCI in ESRD patients are dismal, and CABG is significantly superior to PCI in this subset of patients.
- Subjects
CHRONIC kidney failure; ANGIOPLASTY; CORONARY artery bypass; CORONARY heart disease risk factors; MYOCARDIAL revascularization; HEALTH outcome assessment; META-analysis
- Publication
European Journal of Cardio-Thoracic Surgery, 2013, Vol 43, Issue 3, p459
- ISSN
1010-7940
- Publication type
Article
- DOI
10.1093/ejcts/ezs360