Korean J Nephrol.  2011 Jul;30(4):377-385.

Comparison of the Long-Term Outcome of Coronary Artery Bypass Grafting between Percutaneous Coronary Intervention in End Stage Renal Disease Patients

• Sun HK
• Kim NK
• Cho YJ
• Kang S
• Kim T
• Han KH
• Doh JH
• Lee SY
• Kim CY
• Chang WI
• Han SY

Abstract

PURPOSE
Coronary artery disease is the main cause of morbidity and mortality in dialysis patients. Some observational studies proposed that coronary artery bypass graft (CABG) might provide higher survival benefit than percutaneous coronary intervention (PCI) in dialysis patients. There were not many studies of the comparison between the methods of coronary artery reperfusion therapy. Therefore, we compared the long term survival between PCI and CABG groups in dialysis patients.
METHODS
We selected 104 patients with end stage renal disease (ESRD) who had PCI (N=75) or CABG (N=29) in Ilsan-Paik Hospital from December 1999 to February 2010. We collected data from medical records and performed a retrospective analysis in ESRD patients hospitalized for the first coronary revascularization procedure.
RESULTS
There was no difference in the basic characteristics between the two groups. However, the frequency of more than 3-vessel lesions or less than 30% ejection fraction was higher in the group of CABG than that of PCI. One and three-year survival rates were higher in the PCI group than those in the CABG group. However, there was no difference in the 5 year survival rate between the groups. In subgroup analysis for severe patients with 3-vessel coronary diseases or less than 30% of ejection fraction, there were no statistical differences in the 1, 3 and 5 year survival rates between the groups. In subgroup analysis for the patients maintaining dialysis more than three months, 1, 3, and 5 year survival rates were not statistically different.
CONCLUSION
In ESRD and dialysis patients, there was no difference in the long-term survival between PCI and CABG.

Keyword

Coronary artery bypass; Coronary balloon angioplasty; Chronic kidney failure

MeSH Terms

Angioplasty, Balloon, Coronary
Coronary Artery Bypass
Coronary Artery Disease
Coronary Disease
Coronary Vessels
Dialysis
Humans
Kidney Failure, Chronic
Medical Records
Percutaneous Coronary Intervention
Reperfusion
Retrospective Studies
Survival Rate
Transplants