Abstract
Coronary artery disease (CAD) among patients with diabetes and chronic kidney disease (CKD) is not well studied, and the best treatment for this condition is not established. Our aim was to compare three therapeutic strategies for CAD in diabetic patients stratified by renal function. Patients with multivessel CAD that underwent coronary artery bypass graft (CABG), angioplasty (percutaneous coronary intervention [PCI]), or medical therapy alone (MT) were included. Data were analyzed according to glomerular filtration rate in three strata: normal (>90 mL/min), mild CKD (60 to 89 mL/min), and moderate CKD (30 to 59 mL/min). End points comprised overall rate of mortality, acute myocardial infarction, and need for additional revascularization. Among patients with normal renal function (n = 270), 122 underwent CABG, 72 PCI, and 76 MT; among patients with mild CKD (n = 367), 167 underwent CABG, 92 PCI, and 108 MT; and among patients with moderate CKD (n = 126), 46 underwent CABG, 40 PCI, and 40 MT. Event-free survival was 80.4%, 75.7%, 67.5% for strata 1, 2, and 3, respectively (p = 0.037). Survival rates among patients with no, mild, and moderate CKD are 91.1%, 89.6%, and 76.2%, respectively (p = 0.001) (hazard ratio 0.69; 95% confi...Continue Reading
References
May 16, 2002·Circulation·L A SzczechUNKNOWN Bypass Angioplasty Revascularization Investigation (BARI) Investigators
Feb 7, 2003·Journal of the American College of Cardiology·Guruprasad ManjunathMark J Sarnak
Aug 26, 2003·Journal of the American Society of Nephrology : JASN·Donal N ReddanWilliam F Owen
Jul 21, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Thomas L NickolasJai Radhakrishnan
Sep 24, 2004·The New England Journal of Medicine·Alan S GoChi-yuan Hsu
Sep 29, 2004·Circulation·Brenda R HemmelgarnUNKNOWN Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) Investigators
Jan 29, 2005·The Journal of Thoracic and Cardiovascular Surgery·Ruud M A van de WalH W Thijs Plokker
Jun 24, 2008·The American Journal of Cardiology·Nisha I ParikhCaroline S Fox
Mar 28, 2009·The Annals of Thoracic Surgery·Ye LinShengshou Hu
May 16, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Zhi Jian WangMiao Yu
May 26, 2009·The Journal of Thoracic and Cardiovascular Surgery·Neuza Helena LopesWhady Hueb
Jun 6, 2009·Journal of the American College of Cardiology·Fadi G HageAmi E Iskandrian
Jun 9, 2009·The New England Journal of Medicine·UNKNOWN BARI 2D Study GroupBurton E Sobel
Jul 14, 2010·Cardiology Clinics·Tamar S Polonsky, Francesco Locatelli
Jul 21, 2010·The American Journal of Cardiology·Guha AshrithJames M Wilson
Jan 14, 2011·Diabetes Care·UNKNOWN American Diabetes Association
Jul 2, 2011·Journal of Nippon Medical School = Nippon Ika Daigaku Zasshi·Kouan OriiKazuo Shimizu
Mar 2, 2012·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Samer A M NashefUlf Lockowandt
Nov 6, 2012·The New England Journal of Medicine·Michael E FarkouhUNKNOWN FREEDOM Trial Investigators
Jul 31, 2013·American Heart Journal·Eduardo Gomes LimaRoberto Kalil Filho
Citations
Jul 12, 2018·Current Opinion in Cardiology·Lucas Colombo GodoyMichael E Farkouh
Feb 17, 2018·Journal of the American Heart Association·Jihoon KimHyeon-Cheol Gwon
Oct 1, 2018·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Andrea DenegriSlayman Obeid
Jul 12, 2016·Medicine·Pravesh Kumar BundhunMeng-Hua Chen
Feb 10, 2019·Nutrients·Cláudia Mesquita de CarvalhoLuciana Verçoza Viana
Dec 28, 2018·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Eduardo Gomes LimaRoberto Kalil Filho
Jun 10, 2021·Current Problems in Cardiology·Xue ChenGuoxing Wang
Aug 26, 2021·Aging·Daniel Valente BatistaRoberto Kalil Filho