Comparative efficacy of coronary artery bypass surgery vs. percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease with or without chronic kidney disease
Authors' conclusion
Compared to PCI, the effects of CABG on long-term risks for MACCE observed in the FREEDOM trial are preserved among patients with mild to moderate CKD.
Study context
- Population
- Patients with diabetes mellitus (DM) and multivessel coronary artery disease (CAD), with (estimated glomerular filtration rate (eGFR) <60 mL/min/1.73m2) or without chronic kidney disease (CKD)CKD n = 451
- Comparison
- CABG vs percutaneous coronary intervention (PCI), by CKD status
- Primary endpoint
- Major adverse cardiovascular and cerebrovascular events (MACCE):
- All-cause death
- Stroke
- MI
- Follow-up
- 5 years
Methodological detailsas-treated subgroup analysis
- As-treated subgroup analysis
Primary result
As reported in the abstract
MACCE, by CKD status (subgroup) · median follow-up 3.8 years
CABG vs PCIHazard ratio (95% CI)
CKD: 26.0% vs 35.6%
0.73(0.50–1.05)
No CKD: 16.2% vs 23.6%
0.76(0.58–1.00)
Further findings
MI and repeat revascularization
- Significantly reduced with CABG in both CKD strata
Safety
Stroke
- Non-significantly higher with CABG in both CKD strata
Original publication
Comparative efficacy of coronary artery bypass surgery vs. percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease with or without chronic kidney disease. Eur Heart J. Published 29 August 2016. doi:10.
Summarised from the published abstract; every number is checked against it