Abstract 14384: Cardiovascular Mortality In ESRD Patients Undergoing Coronary Artery Bypass Grafting Vs Percutaneous Coronary Intervention- A Meta Analysis
INTRODUCTION: Patients with End Stage Renal Disease on dialysis have an increased risk for cardiovascular mortality secondary to occlusive coronary artery disease. Optimal revascularization strategy is unclear in this high-risk population.
OBJECTIVE: We have performed a meta- analysis to compare mortality in ESRD patients who have undergone CABG vs PCI.
METHODS: Clinical trials evaluating the mortality in patients with ESRD undergoing CABG and PCI were considered. Studies were obtained using search words in Medline, Pubmed, EMBASE, CINAHL and Cochrane databases. The relative risk across all study groups was computed using Mantel-Hanszel random effects model. Results were calculated with 95% CI and was considered statistically significant if 2-sided alpha error was <.05.
RESULTS: Clinical outcomes in ESRD patients were analyzed. Fifteen trials (n= 53,579) were used for analysis in the ESRD arm. Average age in this group was 62. Average follow-up duration was 25 months. Patients undergoing CABG had a decreased overall mortality compared to PCI in ESRD (0.92 (0.85- 1.00); p=0.0001) patients.
CONCLUSIONS: In patients with ESRD, CABG is associated with decreased mortality when compared to percutaneous coronary intervention.
- © 2013 by American Heart Association, Inc.