Multi-vessel disease percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease

Abstract

Abstract Introduction Coronary revascularization is associated with better prognosis in multivessel coronary artery disease (MV-CAD) chronic kidney disease (CKD) patients. However, whether coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is better remains unknown. Aim of the study To compare outcome of multi-vessel PCI versus CABG in the group of patients with CKD regarding in-hospital and one-year major adverse cardiovascular and cerebrovascular events (MACCE). Methods A retrospective analysis of the data of patients with established CKD with eGFR less than 60 ml/min with MV-CAD who underwent PCI or CABG were compared as regards in-hospital and one-year MACCE. Results A total number of 565 patients were reviewed, 230 patients had PCI while 335 patients had CABG. Comparing both groups regarding in-hospital MACCE, patients who had mutli-vessel PCI had significantly lower in-hospital death, cerebrovascular events and total MACCE than patients who had CABG (P-value = 0.03, 0.01, 0.04 respectively). While comparing both groups regarding 1-year MACCE, patients who had mutli-vessel PCI had significantly lower cerebrovascular events and total MACCE than patients who had CABG (P-value = 0.02, 0.03 respectively). Conclusion On the contrary to previously published data, in a retrospective study to determine which is better in CKD MV-CAD patients, Multi-vessel PCI for CKD patients and MVCAD had advantages over CABG as regards in-hospital and 1-year cerebrovascular accidents (stroke/TIA) and total MACCE. Large randomized controlled trials are needed to confirm our findings. Funding Acknowledgement Type of funding source: None