Comparison of Drug-Eluting Stents and Coronary Artery Bypass Grafting for the Treatment of Multivessel Coronary Artery Disease in Patients With Chronic Kidney Disease

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概要

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• Background: Chronic kidney disease (CKD) is a strong predictor of mortality after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), but the relative efficacy of the 2 revascularization strategies in this context remains unknown. Methods and Results: The 1,069 patients with CKD undergoing revascularization for multivessel coronary disease were evaluated. Of them, 532 patients were treated for 2-vessel disease (97 CABG, 435 PCI) and 537 for 3-vessel disease (248 CABG, 289 PCI). CKD was defined as estimated glomerular filtration rate <60 ml/min. No differences between the PCI and CABG groups in the 2-vessel population were observed in the composite of death, myocardial infarction (MI) or cerebrovascular events (10.6% vs 8.2%, P=0.493) and repeat revascularization (6.7% vs 3.1%, P=0.181) during the 2-year follow-up. In the 3-vessel population, patients undergoing PCI showed similar rate for the composite endpoint (6.7% vs 3.1%, P=0.181), but had a higher incidence of repeat revascularization (12.5% vs 4.4%, P=0.001) compared with the CABG group. After multivariate adjustment, revascularization strategy was not an independent predictor of the composite endpoint. Conclusions: Compared with PCI with a drug-eluting stent, CABG showed a similar incidence of death, MI or cerebrovascular events in patients with multivessel disease and CKD, but was associated with decreased repeat revascularization in the 3-vessel population. (Circ J 2009; 73: 1228-1234)

• 社団法人　日本循環器学会の論文
• 2009-06-20

著者

• Zhou Yu

  Department of Cardiology, An Zhen Hospital, Capital Medical University

• Wang Zhi

  Department of Cardiology, An Zhen Hospital, Capital Medical University

• Yu Miao

  Department of Cardiology, An Zhen Hospital, Capital Medical University

• Liu Yu

  Department Of Chemical And Material Engineering Chang Gung University

• Zhou Yu

  Department Of Cardiology An Zhen Hospital Capital Medical University

• Shi Dong

  Department Of Cardiology Anzhen Hospital Capital Medical University

• Cheng Wan

  Department Of Cardiology Anzhen Hospital Capital Medical University

• Guo Yong

  Department Of Cardiology Anzhen Hospital Capital Medical University

• Zhao Ying

  Department Of Cardiology Anzhen Hospital Capital Medical University

• Wang Zhi

  Department Of Cardiology An Zhen Hospital Capital Medical University

• Yu Miao

  Department Of Cardiology An Zhen Hospital Capital Medical University

• Liu Yu

  Department Of Cardiology Anzhen Hospital Capital Medical University

• Zhao Ying

  Department of Biological Sciences and Biotechnology, Tsinghua University

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