title: Comparison of drug-eluting stents and coronary artery bypass grafting for the treatment of multivessel coronary artery disease in patients with chronic kidney disease.
abstract: BACKGROUND
  Chronic kidney disease (CKD) is a strong predictor of mortality after percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), but the relative efficacy of the 2 revascularization strategies in this context remains unknown.
  
  
  RESULTS
  The 1,069 patients with CKD undergoing revascularization for multivessel coronary disease were evaluated. Of them, 532 patients were treated for 2-vessel disease (97 CABG, 435 PCI) and 537 for 3-vessel disease (248 CABG, 289 PCI). CKD was defined as estimated glomerular filtration rate <60 ml/min. No differences between the PCI and CABG groups in the 2-vessel population were observed in the composite of death, myocardial infarction (MI) or cerebrovascular events (10.6% vs 8.2%, P=0.493) and repeat revascularization (6.7% vs 3.1%, P=0.181) during the 2-year follow-up. In the 3-vessel population, patients undergoing PCI showed similar rate for the composite endpoint (6.7% vs 3.1%, P=0.181), but had a higher incidence of repeat revascularization (12.5% vs 4.4%, P=0.001) compared with the CABG group. After multivariate adjustment, revascularization strategy was not an independent predictor of the composite endpoint.
  
  
  CONCLUSIONS
  Compared with PCI with a drug-eluting stent, CABG showed a similar incidence of death, MI or cerebrovascular events in patients with multivessel disease and CKD, but was associated with decreased repeat revascularization in the 3-vessel population.
authors.affiliation: Department of Cardiology, Anzhen Hospital, Capital Medical University, Beijing, China.
authors.forename: Zhi Jian
authors.initials: ZJ
authors.lastname: Wang
authors.forename: Yu Jie
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Yu Yang
authors.initials: YY
authors.lastname: Liu
authors.forename: Dong Mei
authors.initials: DM
authors.lastname: Shi
authors.forename: Ying Xin
authors.initials: YX
authors.lastname: Zhao
authors.forename: Yong He
authors.initials: YH
authors.lastname: Guo
authors.forename: Wan Jun
authors.initials: WJ
authors.lastname: Cheng
authors.forename: Miao
authors.initials: M
authors.lastname: Yu
mesh_terms: D000368:Aged; D002908:Chronic Disease; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications* / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control; D016016:Proportional Hazards Models; D012042:Registries; D016896:Treatment Outcome