"Comparative analysis of revascularization with percutaneous coronary i" by Waqas Ullah, Mustafeez U. Rahman et al.
 

Comparative analysis of revascularization with percutaneous coronary intervention versus coronary artery bypass surgery for patients with end-stage renal disease: a nationwide inpatient sample database

Department

Internal Medicine

Document Type

Article

Publication Title

Expert Review of Cardiovascular Therapy

Abstract

Background: The role of PCI vs. CABG in patients with coronary artery disease (CAD) and concomitant end-stage renal disease (ESRD) remains unknown.

Research design & methods: The National Inpatient Sample (NIS) (2002-2017) was queried to identify all cases of CAD and ESRD. The relative merits of PCI vs. CABG were determined using a propensity-matched multivariate logistic regression model. Adjusted odds ratios (aOR) for mortality and other in-hospital complications were calculated.

Results: A total of 350,623 [CABG=112,099 (32%) and PCI=238524 (68%)] hospitalizations were included in the analysis. The overall adjusted odds for major bleeding (aOR 1.28, 95% CI 1.25-1.31, p=<0.0001), post-procedure bleeding (aOR 5.19, 95% CI 4.93-5.47, P=<0.0001), sepsis (aOR 1.29, 95% CI 1.26-1.33, P=<0.0001), cardiogenic shock (aOR 1.23, 95% CI 1.20-1.26, P=<0.0001) and in-hospital mortality (aOR 1.65, 95% CI 1.61-1.69, P=<0.0001) were significantly higher for patients undergoing CABG compared with PCI. The need for intra-aortic balloon pump (IABP) placement (aOR 2.52, 95% CI 2.45-2.59, P=<0.001) was higher in the CABG group, while the adjusted odds of vascular complications were similar between the two groups (aOR 0.99, 95% CI 0.94-1.06, P=0.82). As expected, patients undergoing CABG had a higher mean length of stay and mean cost of hospitalization.

Conclusion: CABG in ESRD may be associated with higher in-hospital complications, increased length of stay and higher resource utilization.

DOI

10.1080/14779072.2021.1955350

Publication Date

7-19-2021

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