Abstract 12690: Repeat Coronary Revascularization of Dialysis Patients in the US after Surgical versus Percutaneous Coronary Intervention
Introduction: There are few published data on the comparative risk of repeat coronary revascularization of dialysis pts following surgical versus percutaneous coronary .intervention (PCI). We searched the records of the United States Renal Data System database to identify 12,792 dialysis pts having coronary artery bypass surgery (CAB), drug eluting stents (DES), or bare metal stents (BMS) in 2004–2006. Event-free survival for repeat coronary revascularization (PCI or CAB) and the combined event of repeat revascularization or death was estimated by Kaplan-Meier method and independent predictors were examined in a comorbidity-adjusted Cox model.
Results: There were 3,455 CAB pts, 7,486 DES pts, and 1,851 BMS pts. The tables show event-free survival and predictors for repeat revascularization and the combined endpoint of revascularization/death (age < 65, male, white, hemodialysis, time on dialysis < 2 years, no comorbidity, CAB is reference) with hazard ratio (HR). The risk of repeat revascularization is markedly lower in CAB patients, while DES and BMS patients have similar rates of repeat coronary revascularization. The combined event of repeat coronary revascularization or death is least likely to occur in CAB pts.
Conclusion: Our data indicate that dialysis pts receiving CAB (vs PCI) have a lower rate of repeat coronary revascularization. DES and BMS pts have comparable rates of repeat coronary revascularization.
- © 2010 by American Heart Association, Inc.