title: Long-term outcomes of dialysis patients after coronary revascularization: a population-based cohort study in Taiwan.
abstract: OBJECTIVE
  The outcomes of Chinese patients undergoing dialysis after coronary revascularization are unknown. We examined the outcomes of Taiwanese dialysis patients after coronary artery bypass grafting (CABG), percutaneous transluminal coronary angioplasty (PTCA), or coronary stenting.
  
  
  METHODS
  Using data from the National Health Research Institute database, we determined the outcomes of 1,287 dialysis patients who underwent initial coronary revascularization between 1997 and 2008.
  
  
  RESULTS
  The 7-year overall survival rates were 69 ± 4%, 68 ± 3%, and 57 ± 2% for the CABG, stent, and PTCA patients (p = 0.001), respectively. After demographic and comorbidity adjustment, hazard ratios (HRs) for all-cause death in the CABG (vs. PTCA) and stent (vs. PTCA) patients were 0.695 (p = 0.015) and 0.721 (p = 0.009). Additionally, no significant difference in all-cause death was found between the CABG and stent patients. Moreover, the ≥65-year-old CABG group patients and the <65-year-old coronary stent group patients showed better survival than the PTCA group patients. Compared with the PTCA and CABG groups, the coronary stent group was significantly associated with a higher risk for recurrent acute myocardial infarction (AMI). Based on age stratification, the ≥65-year-old stent group had a higher risk for recurrent AMI than the PTCA group (HR, 1.562; p = 0.026).
  
  
  CONCLUSIONS
  Chinese patients undergoing dialysis who underwent CABG or coronary stenting had better survival than those who underwent PTCA. Moreover, being ≥65 years old, CABG shows better survival compared with PTCA; being <65 years old, coronary stenting show better survival compared with PTCA.
authors: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
authors: Chu-lin
authors: CL
authors: Chou
authors: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan.
authors: Tsung-cheng
authors: TC
authors: Hsieh
authors: Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Chih-hsien
authors: CH
authors: Wang
authors: Division of Gastroenterology, Department of Medicine, Buddhist Dalin Tzu Chi Hospital, Chiayi, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors: Tsung-hsing
authors: TH
authors: Hung
authors: Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Yu-hsien
authors: YH
authors: Lai
authors: Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Yi-ya
authors: YY
authors: Chen
authors: Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Yu-li
authors: YL
authors: Lin
authors: Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Chiu-huang
authors: CH
authors: Kuo
authors: Division of General Medicine, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.
authors: Ya-ju
authors: YJ
authors: Wu
authors: Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan; Division of Nephrology, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; School of Medicine, Tzu Chi University, Hualien, Taiwan. Electronic address: fangtechao@yahoo.com.tw.
authors: Te-chao
authors: TC
authors: Fang
mesh_terms: D000367:Age Factors; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015331:Cohort Studies; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology / Q000401:mortality; D006435:Renal Dialysis; D015607:Stents; D015996:Survival Rate; D013624:Taiwan; D016896:Treatment Outcome
keywords: Coronary artery bypass grafting; Dialysis; Percutaneous transluminal coronary angioplasty; Stent