Collins A, Ma J, Herzog C
A national comparison of PTCA vs. CAB in chronic dialysis
patients
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1443 1996
Much of the morbidity and mortality of dialysis patients is due to
accelerated arteriosclerotic cardiovascular disease. The authors had
previously reported that dialysis patients at their own hospital with
coronary disease had similar survival rates when treated with either PTCA or
CAB but that PTCA led to more comorbid events.
This study made a similar comparison of PTCA and CAB in dialysis patients
using data from the US Renal Disease Survey. They found records of 5,473
patients given PTCA and 6,798 patients given CAB. Although in-hospital
mortality for CAB was nearly 3 times higher than for PTCA (14.2% vs. 5.1%),
the CAB patients who survived had a significantly lower incidence of new
myocardial infarctions and other cardiac complications. Overall, long-term
survival was comparable in both groups (27.2% vs. 27.8%). These results
confirm their earlier findings.
Comment:
These results are consistent with earlier reports that dialysis patients can
tolerate invasive treatments for coronary insufficiency. Although diabetes
slightly increased the risk ratio, it is not clear from the report whether
the diabetics, who have some of the highest risk for coronary disease among
dialysis patients, did better with CAB or PTCA.
(Don Feinfeld MD, State University of New York at Stony Brook)
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Am Soc Nephrol
CRF by organ system :
Cardiovascular/Hypertension