Research has indicated that open-heart surgery may be more effective than angioplasty for treating coronary heart disease in patients with kidney failure. A significant portion of individuals undergoing dialysis suffer from blocked arteries, yet there is limited guidance on the best treatment method since these patients are often excluded from major studies.
"It is important to note that because our study was observational, our results cannot prove that CABG is better; only a randomized trial can do that," said Dr. Chang. "However, our study does offer guidance to patients and providers who must make these tough decisions and suggests that in carefully selected patients on dialysis with multivessel coronary heart disease, CABG may be preferred rather than PCI."
Because organizing a randomized trial of CABG and PCI in patients on dialysis would be quite difficult, observational studies such as this one may be the best way to compare the two strategies.
Another major finding would be that CABG was associated with a 13% lower risk of death and a 12% lower risk of either dying or having a heart attack.
One major finding was that overall survival rates were poor, with five-year survival rates of 22% to 25% irrespective of revascularization strategy. (Five-year survival rates in patients without kidney disease are over 90%).
Tara Chang, MD, Wolfgang Winkelmayer, MD, ScD (Stanford University School of Medicine) and their colleagues examined a database of all patients on dialysis in the United States with primary Medicare coverage to determine which is the best revascularization strategy: CABG or PCI.
It was identified through the data that nearly 22,000 dialysis patients underwent CABG or PCI between 1997 and 2009.
There were many major findings.
Open heart surgery (coronary artery bypass grafting, or CABG) and angioplasty (percutaneous coronary intervention, or PCI).
While 30% to 60% of kidney failure patients on dialysis have blocked arteries surrounding the heart, there is little information regarding how to optimally fix the life-threatening problem in these individuals.
This is due to the fact that most dialysis (The clinical purification of blood thus, as a substitute for the normal function of the kidney) patients have been excluded from the two available procedures
Out of two available for opening blocked arteries , one appears to be safer than the other.
This information was shown through the study made by the Journal of the American Society of Nephrology (JASN).
Open Heart Surgery and Angioplasty are the two procedures.
Heart Disease is the leading cause of patients with kidney failure.
Coronary heart disease affects 30% to 60% of kidney failure patients.
