PMID- 24996550 OWN - NLM STAT- MEDLINE DCOM- 20150211 LR - 20220409 IS - 1879-1913 (Electronic) IS - 0002-9149 (Linking) VI - 114 IP - 4 DP - 2014 Aug 15 TI - Percutaneous coronary intervention versus coronary artery bypass grafting in patients with end-stage renal disease requiring dialysis (5-year outcomes of the CREDO-Kyoto PCI/CABG Registry Cohort-2). PG - 555-61 LID - S0002-9149(14)01227-2 [pii] LID - 10.1016/j.amjcard.2014.05.034 [doi] AB - Ischemic heart disease is a major risk factor for morbidity and mortality in patients with end-stage renal disease. However, long-term benefits of percutaneous coronary intervention (PCI) relative to coronary artery bypass grafting (CABG) in those patients is still unclear in the drug-eluting stent era. We identified 388 patients with multivessel and/or left main disease with end-stage renal disease requiring dialysis among 15,939 patients undergoing first coronary revascularization enrolled in the Coronary REvascularization Demonstrating Outcome Study in Kyoto PCI/CABG Registry Cohort-2 (PCI: 258 patients and CABG: 130 patients). The CABG group included more patients with 3-vessel (38% vs 57%, p <0.001) and left main disease (10% vs 34%, p <0.001). Preprocedural Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery score in the CABG group was significantly higher than that in the PCI group (23.5 +/- 8.7 vs 29.4 +/- 11.0, p <0.001). Unadjusted 30-day mortality was 2.7% for PCI and 5.4% for CABG. Cumulative 5-year all-cause mortality was 52.3% for PCI and 49.9% for CABG. Propensity score-adjusted all-cause mortality was not different between PCI and CABG (hazard ratio [HR] 1.33, 95% confidence interval [CI] 0.85 to 2.09, p = 0.219). However, the excess risk of PCI relative to CABG for cardiac death was significant (HR 2.10, 95% CI 1.11 to 3.96, p = 0.02). The risk of sudden death was also higher after PCI (HR 4.83, 95% CI 1.01 to 23.08, p = 0.049). The risk of myocardial infarction after PCI tended to be higher than after CABG (HR 3.30, 95% CI 0.72 to 15.09, p = 0.12). The risk of any coronary revascularization after PCI was markedly higher after CABG (HR 3.78, 95% CI 1.91 to 7.50, p <0.001). Among the 201 patients who died during the follow-up, 94 patients (47%) died from noncardiac morbidities such as stroke, respiratory failure, and renal failure. In patients with multivessel and/or left main disease undergoing dialysis, 5-year outcomes revealed that CABG relative to PCI reduced the risk of cardiac death, sudden death, myocardial infarction, and any revascularization. However, the risk of all-cause death was not different between PCI and CABG. CI - Copyright (c) 2014 Elsevier Inc. All rights reserved. FAU - Marui, Akira AU - Marui A AD - Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. Electronic address: marui@kuhp.kyoto-u.ac.jp. FAU - Kimura, Takeshi AU - Kimura T AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Nishiwaki, Noboru AU - Nishiwaki N AD - Department of Cardiovascular Surgery, Nara Hospital, Kinki University Faculty of Medicine, Ikoma, Japan. FAU - Mitsudo, Kazuaki AU - Mitsudo K AD - Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Komiya, Tatsuhiko AU - Komiya T AD - Department of Cardiovascular Surgery, Kurashiki Central Hospital, Kurashiki, Japan. FAU - Hanyu, Michiya AU - Hanyu M AD - Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Japan. FAU - Shiomi, Hiroki AU - Shiomi H AD - Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Tanaka, Shiro AU - Tanaka S AD - Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Sakata, Ryuzo AU - Sakata R AD - Department of Cardiovascular Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. CN - CREDO-Kyoto PCI/CABG Registry Cohort-2 Investigators LA - eng PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't DEP - 20140606 PL - United States TA - Am J Cardiol JT - The American journal of cardiology JID - 0207277 SB - IM MH - Aged MH - Coronary Artery Bypass/*methods MH - Coronary Artery Disease/complications/mortality/*surgery MH - Drug-Eluting Stents MH - Female MH - Follow-Up Studies MH - Humans MH - Japan/epidemiology MH - Kidney Failure, Chronic/*complications/mortality/therapy MH - Male MH - Percutaneous Coronary Intervention/*methods MH - Propensity Score MH - *Registries MH - *Renal Dialysis MH - Retrospective Studies MH - Risk Factors MH - Survival Rate/trends MH - Time Factors MH - Treatment Outcome FIR - Kimura, Takeshi IR - Kimura T FIR - Matsuda, Mitsuo IR - Matsuda M FIR - Mitsuoka, Hirokazu IR - Mitsuoka H FIR - Nakagawa, Yoshihisa IR - Nakagawa Y FIR - Fujiwara, Hisayoshi IR - Fujiwara H FIR - Takatsu, Yoshiki IR - Takatsu Y FIR - Taniguchi, Ryoji IR - Taniguchi R FIR - Nohara, Ryuji IR - Nohara R FIR - Murakami, Tomoyuki IR - Murakami T FIR - Takeda, Teruki IR - Takeda T FIR - Nobuyoshi, Masakiyo IR - Nobuyoshi M FIR - Iwabuchi, Masashi IR - Iwabuchi M FIR - Tatami, Ryozo IR - Tatami R FIR - Shirotani, Manabu IR - Shirotani M FIR - Kita, Toru IR - Kita T FIR - Furukawa, Yutaka IR - Furukawa Y FIR - Ehara, Natsuhiko IR - Ehara N FIR - Kato, Hiroshi IR - Kato H FIR - Eizawa, Hiroshi IR - Eizawa H FIR - Ishii, Katsuhisa IR - Ishii K FIR - Tanaka, Masaru IR - Tanaka M FIR - Lee, Jong-Dae IR - Lee JD FIR - Nakano, Akira IR - Nakano A FIR - Takizawa, Akinori IR - Takizawa A FIR - Takahashi, Masaaki IR - Takahashi M FIR - Horie, Minoru IR - Horie M FIR - Takashima, Hiroyuki IR - Takashima H FIR - Tamura, Takashi IR - Tamura T FIR - Takahashi, Mamoru IR - Takahashi M FIR - Tei, Chuwa IR - Tei C FIR - Hamasaki, Shuichi IR - Hamasaki S FIR - Kambara, Hirofumi IR - Kambara H FIR - Doi, Osamu IR - Doi O FIR - Kaburagi, Satoshi IR - Kaburagi S FIR - Mitsudo, Kazuaki IR - Mitsudo K FIR - Kadota, Kazushige IR - Kadota K FIR - Miki, Shinji IR - Miki S FIR - Mizoguchi, Tetsu IR - Mizoguchi T FIR - Ogawa, Hisao IR - Ogawa H FIR - Sugiyama, Seigo IR - Sugiyama S FIR - Hattori, Ryuichi IR - Hattori R FIR - Aoyama, Takeshi IR - Aoyama T FIR - Araki, Makoto IR - Araki M FIR - Suwa, Satoru IR - Suwa S FIR - Sakata, Ryuzo IR - Sakata R FIR - Marui, Akira IR - Marui A FIR - Onoe, Masahiko IR - Onoe M FIR - Yamanaka, Kazuo IR - Yamanaka K FIR - Fujiwara, Keiichi IR - Fujiwara K FIR - Ohno, Nobuhisa IR - Ohno N FIR - Hanyu, Michiya IR - Hanyu M FIR - Matsushita, Tsutomu IR - Matsushita T FIR - Nishiwaki, Noboru IR - Nishiwaki N FIR - Yoshida, Yuichi IR - Yoshida Y FIR - Okada, Yukikatsu IR - Okada Y FIR - Nasu, Michihiro IR - Nasu M FIR - Nakayama, Shogo IR - Nakayama S FIR - Tanaka, Kuniyoshi IR - Tanaka K FIR - Koshiji, Takaaki IR - Koshiji T FIR - Morioka, Koichi IR - Morioka K FIR - Shimamoto, Mitsuomi IR - Shimamoto M FIR - Yamazaki, Fumio IR - Yamazaki F FIR - Nishizawa, Junichiro IR - Nishizawa J FIR - Aota, Masaki IR - Aota M FIR - Tabata, Takafumi IR - Tabata T FIR - Imoto, Yutaka IR - Imoto Y FIR - Yamamoto, Hiroyuki IR - Yamamoto H FIR - Matsuda, Katsuhiko IR - Matsuda K FIR - Nara, Masafumi IR - Nara M FIR - Komiya, Tatsuhiko IR - Komiya T FIR - Nakajima, Hiroyuki IR - Nakajima H FIR - Kawasuji, Michio IR - Kawasuji M FIR - Moriyama, Syuji IR - Moriyama S FIR - Tanbara, Keiichi IR - Tanbara K FIR - Kitagawa, Kumiko IR - Kitagawa K FIR - Yamauchi, Misato IR - Yamauchi M FIR - Okamoto, Naoko IR - Okamoto N FIR - Fujino, Yumika IR - Fujino Y FIR - Tezuka, Saori IR - Tezuka S FIR - Saeki, Asuka IR - Saeki A FIR - Hanazawa, Miya IR - Hanazawa M FIR - Sato, Yuki IR - Sato Y FIR - Hibi, Chikako IR - Hibi C FIR - Sasae, Hitomi IR - Sasae H FIR - Takinami, Emi IR - Takinami E FIR - Uchida, Yuriko IR - Uchida Y FIR - Yamamoto, Yuko IR - Yamamoto Y FIR - Nishida, Satoko IR - Nishida S FIR - Yoshimoto, Mai IR - Yoshimoto M FIR - Maeda, Sachiko IR - Maeda S FIR - Miki, Izumi IR - Miki I FIR - Minematsu, Saeko IR - Minematsu S EDAT- 2014/07/06 06:00 MHDA- 2015/02/12 06:00 CRDT- 2014/07/06 06:00 PHST- 2014/02/20 00:00 [received] PHST- 2014/05/13 00:00 [revised] PHST- 2014/05/13 00:00 [accepted] PHST- 2014/07/06 06:00 [entrez] PHST- 2014/07/06 06:00 [pubmed] PHST- 2015/02/12 06:00 [medline] AID - S0002-9149(14)01227-2 [pii] AID - 10.1016/j.amjcard.2014.05.034 [doi] PST - ppublish SO - Am J Cardiol. 2014 Aug 15;114(4):555-61. doi: 10.1016/j.amjcard.2014.05.034. Epub 2014 Jun 6.