Abstract 12633: Long-term Survival of Dialysis Patients in the US after Surgical versus Percutaneous Coronary Revascularization
Introduction: There are few published data on the comparative long-term survival of dialysis patients undergoing surgical versus percutaneous coronary revascularization in the era of drug-eluting stents (DES). We searched the records of the United States Renal Data System database to identify 10,941 dialysis pts having coronary artery bypass surgery (CAB) or DES in 2004–2006. Long-term survival was estimated by Kaplan-Meier method and independent predictors of death were examined in a comorbidity-adjusted Cox model.
Results:There were 3,455 CAB pts and 7,486 DES patients. The tables show survival and predictors of death, (age < 65, male, white, hemodialysis, time on dialysis < 2 years, no comorbidity, CAB is reference) with hazard ratio (HR), as well as estimated survival within CAB patients related to utilization of internal mammary grafts [IMG(+) or IMG (-)]. DES patients have better survival at 12 months, but after 18 months CAB patients have better outcome. CAB patients receiving internal mammary grafts (68% of CAB pts, n=2356) do significantly better than those without (Log-Rank p-value = 0.0005).
Conclusion: Our data suggest that drug-eluting stents provide the best first year survival, but unadjusted long-term survival is best in CAB patients receiving internal mammary grafts.
- © 2010 by American Heart Association, Inc.