Three-year clinical outcome of unprotected left main coronary artery disease patients complicated with chronic kidney disease treated by coronary artery bypass graft versus percutaneous coronary intervention.

Irish Journal of Medical Science
Xun WangXianghua Fu

Abstract

This study aimed to compare the incidence of major adverse cardiac and cerebrovascular events (MACCE) after coronary artery bypass graft (CABG) or after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) in unprotected left main coronary artery disease (ULMCAD) patients complicated with chronic kidney disease (CKD). Three hundred sixty-eight ULMCAD patients complicated with CKD who underwent first ever CABG (n = 207) or PCI with DES (n = 161) were recruited in this prospective cohort study. Patients were followed up to MACCE occurrence or 36 months after operations, and accumulating MACCE occurrence was calculated. Accumulating MACCE occurrence was decreased in CABG group compared with PCI group (P = 0.007). Subgroup analysis showed that CKD stage positively correlated with accumulating MACCE occurrence in total patients (P = 0.006) and in PCI-treated patients (P = 0.018), but not in CABG-treated patients (P = 0.217). Further univariate Cox's regression model displayed that CABG (versus (vs.) PCI) (P = 0.008) was associated with lower accumulating MACCE occurrence, while age (≥ 65 years) (P = 0.048), hyperlipidemia (P = 0.013), diabetes (P = 0.012), previous heart failure (P = 0.011), previous stroke (P = 0....Continue Reading

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