Outcomes of different revascularization therapies treating coronary atherosclerotic heart disease complicated with moderate to severe renal dysfunction
Zhao Xuedong
Zhang Yujiao
Zheng Wen
Wang Chunmei
Wang Xiao
Nie Shaoping
Abstract：Objective To analyze short and long term outcomes of drug-eluting sent (DES) implantation and coronary artery bypass graft (CABG) surgery in coronary atherosclerotic heart disease (CHD) patients with moderate to severe renal dysfunction.Methods Totally 693 CHD patients with moderate to severe renal dysfunction who had DES implantation or CABG surgery from July 1,2003 to September 30,2005 in Beijing Anzhen Hospital,Capital Medical University were retrospectively analyzed.Major adverse cardiac and cerebral events (MACCE)were recorded in DES group (429 cases) and CABG group (264 cases).Propensity score matching was used to reduce selection bias.Results Proportions of hypertension history and ST-elevation myocardial infarction history in CABG group were significantly lower and proportions of left main coronary lesion and chronic total occlusion were significantly higher than those in DES group (P ＜ 0.05).A total of 63 patients (9.1％) died during about 2 years follow-up(41 cardiac death).The all cause mortality in CABG group was significantly higher than that in DES group [12.9％ (31/264) vs 9.8％ (32/429)] (P ＜ 0.05);the in-hospital death rate and 30 d death rate in CABG group were significantly higher than those in DES group[7.6％ (20/264) vs 1.4％ (6/429),8.0％ (21/264) vs 1.9％ (8/429)] (P ＜ 0.01).The repeat revascularization rate in CABG group was significantly lower than that in DES group[1.6％ (3/264) vs 13.7％ (28/429)] (P ＜ 0.01).Based on propensity scores(105 cases in each group,no differences of clinical baseline data between groups),Kaplan-Meier survival analysis showed no significant difference of death rate and MACCE rate between groups(P ＞ 0.05).Conclusions Revascularization therapies of DES and CABG are safe and effective for CHD with moderate to severe renal dysfunction.Critical patients with short life expectancy are more feasible to have minimally invasive coronary intervention strategy.
Keywords：Coronary artery bypass graftDrug-eluting stentsRenal insufficiencyRevascularization
Publication Date：2017-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 677-681 )