The following is a summary of “Meta-analysis of clinical adverse events after CABG vs. PCI in patients with chronic kidney disease and coronary artery disease,” published in the November 2023 issue of Cardiology by Luo et al.

Researchers evaluated the effectiveness and postoperative clinical adverse events of coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) in chronic kidney disease (CKD) patients with comorbid coronary artery disease (CAD).

They screened all randomized controlled trials (RCTs) that evaluated the therapeutic effects of CABG and PCI in participants with CAD and CKD. They assessed the impact of these interventions on postoperative clinical adverse events and main adverse cardiovascular and cerebrovascular events (MACCEs). The databases included CNKI, CBM, Wan Fang, VIP, Embase, PubMed, and Cochrane Library clinical controlled trials. Adhering to PRISMA 2020 criteria, data extraction and quality control were assessed with the modified Jadad rating scale. Meta-analysis was performed using STATA 16.0 software.

The results showed  5 RCTs with a total of 1,198 patients. Participants were divided into PCI (n = 604) and CABG (n = 594). Meta-analysis revealed that long-term survival outcomes for CAD patients with CKD undergoing PCI were worse compared to CABG. This included long-term MACCEs (RR = 1.59, 95%CI: 1.04–2.43) and long-term repeated revascularization (RR = 2.48, 95%CI: 1.76–3.49). Additionally, the CABG group exhibited significantly lower rates of cardiac death (RR = 1.68, 95%CI: 1.04–2.71) and cerebrovascular accidents (RR = 1.74, 95%CI: 1.04–2.90) compared to the PCI group.

Investigators concluded that CABG demonstrated superior long-term outcomes compared to PCI in CKD patients with CAD, warranting further prospective RCTs to optimize revascularization strategies.

Source: bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-023-03560-w