Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial

Aoki, Jiro; Ong, Andrew T.L.; Hoye, Angela; Herwerden, Lex A. van; Sousa, J. Eduardo; Jatene, Adib; Bonnier, J. J. R. M.; Schönberger, Jacques P.A.M.; Buller, Nigel; Bonser, Robert S.; Lindeboom, Wietze; Unger, Felix; Serruys, Patrick W.

doi:10.1093/eurheartj/ehi288

Cited by 59 publications

(36 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Although some studies included single-vessel disease patients, the small number did not influence our analysis. Six studies included all types of dialysis patients [9, 18, 20-23], 10 studies included DES-only patients, and 1 study included bare-metal stent-only patients [8, 10, 11, 17, 19, 21-26]. Four studies included both DES and bare-metal stent patients [18, 20, 27, 28], and 2 studies did not report the type of stent used [9, 29].…”

Section: Resultsmentioning

confidence: 99%

Multivessel Coronary Revascularization Strategies in Patients with Chronic Kidney Disease: A Meta-Analysis

Luo

Fang

2019

Cardiorenal Med

View full text Add to dashboard Cite

Background: Early revascularization can lead to better prognosis in multivessel coronary artery disease (CAD) patients with chronic kidney disease (CKD). However, whether coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) is better remains unknown. Methods: We searched PubMed and the Cochrane Library database from inception until December 9, 2017, for articles that compare outcomes of CABG and PCI in multivessel CAD patients with CKD. We pooled the odds ratios with a fixed-effects model when I² < 50% or a random-effects model when I² > 75% and conducted heterogeneity and quality assessments as well as publication bias analyses. Results: A total of 17 studies with 62,343 patients were included. Compared with CABG, the pooled analysis showed that PCI had a lower risk of short-term all-cause death (OR, 0.56; 95% CI, 0.37–0.84) and cerebrovascular accidents (OR, 0.65; 95% CI, 0.53–0.79) but a higher risk of cardiac death (OR, 1.29; 95% CI, 1.21–1.37), myocardial infarction (MI) (OR, 1.73; 95% CI, 1.35–2.21), and repeat revascularization (RR) (OR, 3.9; 95% CI, 2.99–5.09). There was no significant difference in the risk of long-term all-cause death (OR, 1.08; 95% CI, 0.95–1.23) and major adverse cardiac and cerebrovascular events (MACCE) (OR, 1.58; 95% CI, 0.99–2.52) between the PCI and CABG groups. A subgroup analysis restricted to patients treated with dialysis or with PCI-drug-eluting stent yielded similar results. Conclusions: PCI for patients with CKD and multivessel disease (multivessel CAD) had advantages over CABG with regard to short-term all-cause death and cerebrovascular accidents, but disadvantages regarding the risk of myocardial death, MI, and RR; there was no significant difference in the risk of long-term all-cause death and MACCE. Large randomized controlled trials are needed to confirm our findings.

show abstract

Section: Resultsmentioning

confidence: 99%

Multivessel Coronary Revascularization Strategies in Patients with Chronic Kidney Disease: A Meta-Analysis

Luo

Fang

2019

Cardiorenal Med

View full text Add to dashboard Cite

show abstract

“…[18][19][20] This strong association between CKD and mortality has been most extensively established in a recent collaborative metaanalysis by the CKD Prognosis Consortium involving 21 studies with over 2.1 million patients with adequate global representation. 21 During a median follow-up of 8 years, eGFR and albuminuria were associated with all-cause and cardiovascular mortality independently of each other and traditional risk factors.…”

Section: Cardiovascular Morbidity In Patients With Ckd-pathophysiologmentioning

confidence: 96%

Non-invasive risk assessment in patients with chronic kidney disease

Hakeem

Bhatti

Trevino

et al. 2011

Journal of Nuclear Cardiology

View full text Add to dashboard Cite

“…[87][88][89][90][91][92][93][94][95][96][97][98][99][100] Within the cardiology community, some degree of pessimism about the efficacy of interventions to reduce the incidence of cardiovascular events in patients with CKD (versus those without CKD) exists, leading to differences in therapeutic decision-making, which subsequently confounds the observational literature. 90,93,[101][102][103][104][105][106][107][108] Nonetheless, the exclusion of these patients from randomized studies has made it difficult to understand which therapies are most efficacious in these populations. 109 Some re-analysis of data from existing studies, stratified by eGFR category, has improved our understanding of the utility of renin-angiotensin-aldosterone system blockade in patients with CKD, irrespective of stage.…”

Section: Acute Kidney Injury and Ckdmentioning

confidence: 99%

Early detection of CKD: the benefits, limitations and effects on prognosis

Levin

Stevens

2011

Nat Rev Nephrol

View full text Add to dashboard Cite

The past decade has seen an increasing focus on chronic kidney disease (CKD) and its attendant complications, which has resulted in improved understanding of their impact on health-care resources. The early detection of CKD has been facilitated by the implementation of routine reporting of estimated glomerular filtration rates (eGFRs) and by education of primary care physicians on the implications of detecting a decreased eGFR with respect to patient safety as well as to cardiovascular and renal outcomes. The goals of early CKD detection are to prevent CKD progression and associated complications, thus improving patient outcomes and reducing the impact of CKD on health-care resources. This Review examines the benefits of the early detection of CKD, and describes the limitations of current knowledge with respect to screening, early detection and treatment, as well as the unintended consequences of detection. In addition, this article highlights what is currently known about cardiovascular and renal outcomes and the effects of intervention in patients with CKD.

show abstract

Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial

Cited by 59 publications

References 27 publications

Multivessel Coronary Revascularization Strategies in Patients with Chronic Kidney Disease: A Meta-Analysis

Multivessel Coronary Revascularization Strategies in Patients with Chronic Kidney Disease: A Meta-Analysis

Non-invasive risk assessment in patients with chronic kidney disease

Early detection of CKD: the benefits, limitations and effects on prognosis

Contact Info

Product

Resources

About