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Survival after coronary revascularization among patients with kidney disease.
Circulation. 2004 Oct 05; 110(14):1890-5.Circ

Abstract

BACKGROUND

The optimal approach to revascularization in patients with kidney disease has not been determined. We studied survival by treatment group (CABG, percutaneous coronary intervention [PCI], or no revascularization) for patients with 3 categories of kidney function: dialysis-dependent kidney disease, non-dialysis-dependent kidney disease, and a reference group (serum creatinine <2.3 mg/dL).

METHODS AND RESULTS

Data were derived from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), which captures information on all patients undergoing cardiac catheterization in Alberta, Canada. Characteristics and patient survival in 662 dialysis patients (1.6%) and 750 non-dialysis-dependent kidney disease patients (1.8%) were compared with the remainder of the 40,374 patients (96.6%). For the reference group, the adjusted 8-year survival rates for CABG, PCI, and no revascularization (NR) were 85.5%, 80.4%, and 72.3%, respectively (P<0.001 for CABG versus NR; P<0.001 for PCI versus NR). Adjusted survival rates were 45.9% for CABG, 32.7% for PCI, and 29.7% for NR in the nondialysis kidney disease group (P<0.001 for CABG versus NR; P=0.48 for PCI versus NR) and 44.8% for CABG, 41.2% for PCI, and 30.4% for NR in the dialysis group (P=0.003 for CABG versus NR; P=0.03 for PCI versus NR).

CONCLUSIONS

Compared with no revascularization, CABG was associated with better survival in all categories of kidney function. PCI was also associated with a lower risk of death than no revascularization in reference patients and dialysis-dependent kidney disease patients but not in patients with non-dialysis-dependent kidney disease. The presence of kidney disease or dependence on dialysis should not be a deterrent to revascularization, particularly with CABG.

Authors+Show Affiliations

Department of Medicine, University of Calgary, Calgary, Alberta, Canada. brenda.hemmelgarn@calgaryhealthregion.ca.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

15451786

Citation

Hemmelgarn, Brenda R., et al. "Survival After Coronary Revascularization Among Patients With Kidney Disease." Circulation, vol. 110, no. 14, 2004, pp. 1890-5.
Hemmelgarn BR, Southern D, Culleton BF, et al. Survival after coronary revascularization among patients with kidney disease. Circulation. 2004;110(14):1890-5.
Hemmelgarn, B. R., Southern, D., Culleton, B. F., Mitchell, L. B., Knudtson, M. L., & Ghali, W. A. (2004). Survival after coronary revascularization among patients with kidney disease. Circulation, 110(14), 1890-5.
Hemmelgarn BR, et al. Survival After Coronary Revascularization Among Patients With Kidney Disease. Circulation. 2004 Oct 5;110(14):1890-5. PubMed PMID: 15451786.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Survival after coronary revascularization among patients with kidney disease. AU - Hemmelgarn,Brenda R, AU - Southern,Danielle, AU - Culleton,Bruce F, AU - Mitchell,L Brent, AU - Knudtson,Merril L, AU - Ghali,William A, AU - ,, Y1 - 2004/09/27/ PY - 2004/9/29/pubmed PY - 2005/5/28/medline PY - 2004/9/29/entrez SP - 1890 EP - 5 JF - Circulation JO - Circulation VL - 110 IS - 14 N2 - BACKGROUND: The optimal approach to revascularization in patients with kidney disease has not been determined. We studied survival by treatment group (CABG, percutaneous coronary intervention [PCI], or no revascularization) for patients with 3 categories of kidney function: dialysis-dependent kidney disease, non-dialysis-dependent kidney disease, and a reference group (serum creatinine <2.3 mg/dL). METHODS AND RESULTS: Data were derived from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), which captures information on all patients undergoing cardiac catheterization in Alberta, Canada. Characteristics and patient survival in 662 dialysis patients (1.6%) and 750 non-dialysis-dependent kidney disease patients (1.8%) were compared with the remainder of the 40,374 patients (96.6%). For the reference group, the adjusted 8-year survival rates for CABG, PCI, and no revascularization (NR) were 85.5%, 80.4%, and 72.3%, respectively (P<0.001 for CABG versus NR; P<0.001 for PCI versus NR). Adjusted survival rates were 45.9% for CABG, 32.7% for PCI, and 29.7% for NR in the nondialysis kidney disease group (P<0.001 for CABG versus NR; P=0.48 for PCI versus NR) and 44.8% for CABG, 41.2% for PCI, and 30.4% for NR in the dialysis group (P=0.003 for CABG versus NR; P=0.03 for PCI versus NR). CONCLUSIONS: Compared with no revascularization, CABG was associated with better survival in all categories of kidney function. PCI was also associated with a lower risk of death than no revascularization in reference patients and dialysis-dependent kidney disease patients but not in patients with non-dialysis-dependent kidney disease. The presence of kidney disease or dependence on dialysis should not be a deterrent to revascularization, particularly with CABG. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15451786/Survival_after_coronary_revascularization_among_patients_with_kidney_disease_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000143629.55725.D9?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -