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PCI versus CABG in diabetic patients with chronic kidney disease

Wednesday, October 12, 2016

Submitted by

Stuart Head

Source

Source Name: Eur Heart J

Source URL: http://eurheartj.oxfordjournals.org/content/early/2016/08/27/eurheartj.ehw378

Author(s)

Usman Baber, Michael E. Farkouh, Yaron Arbel, Paul Muntner, George Dangas, Michael J. Mack, Taye H. Hamza, Roxana Mehran, Valentin Fuster

In the FREEDOM trial, 1900 diabetic patients were randomized between coronary bypass surgery and percutaneous coronary intervention (PCI). Of these, 451 patients had chronic kidney disease (CKD) with a GFR 30-60 mL/min/1.73m2, and the remaining patients were categorized as having no CKD. In both groups, bypass surgery performed better over 5-year follow-up than PCI in patients with CKD (26.0% versus 35.6%; HR=0.73, 95% CI 0.50-1.05) and no CKD (16.2% verus 23.6%; HR=0.76, 95% CI 0.58-1.00). Therefore, independent of chronic kidney disease, diabetic patients with multivessel disease should undergo CABG.