Abstract 11565: Revascularization Prior to Renal Transplantation is Not Superior to Medical Therapy Alone in Reducing Mortality in Patients with Coronary Artery Disease

Abstract

Introduction: Coronary artery disease (CAD) is a common cause of mortality in end stage renal disease and is highly prevalent in patients with chronic kidney disease. Therefore, patients with end stage renal disease are routinely screened for heart disease prior to renal transplant. The role of revascularization remains unclear in this process. Hypothesis: There is no difference in all-cause and cardiovascular (CV) mortality in renal transplant patients with coronary artery disease who underwent revascularization prior to transplant when compared to those who were treated with optimum medical therapy (OMT). Methods: Medline, Scopus and Cochrane Central Register of Controlled Trials were systematically searched to identify relevant studies. Primary outcomes of interest were all-cause mortality, CV mortality and major adverse cardiovascular events (MACE). Results: We included six studies for this metanalysis. There was no significant difference in all-cause mortality (RR 1.16; 95% CI 0.63 - 2.12), CV mortality (RR 0.71; 95% CI 0.24 - 2.09) or MACE (RR 0.78; 95% CI 0.30 - 2.07) in renal transplant patients with CAD who underwent revascularization prior to renal transplant compared to those who were on OMT alone for CAD. Conclusions: Studies suggest that revascularization is not superior to OMT for CAD in patients undergoing renal transplant therapy.