Skip to main content

Revascularization Strategies in Chronic Kidney Disease: Percutaneous Coronary Interventions Versus Coronary Artery Bypass Graft

  • Chapter
  • First Online:
Kidney Disease in the Cardiac Catheterization Laboratory

Abstract

Both cardiovascular disease and chronic kidney disease are responsible for significant morbidity and mortality globally. Chronic kidney disease (CKD) is associated with the development and progression of atherosclerotic cardiovascular disease. In addition to traditional cardiovascular risk factors such as hypertension, smoking, diabetes mellitus, and hyperlipidemia, patients with CKD also carry nontraditional risk factors such as increased vascular calcification and myocardial fibrosis. In fact, patients with end-stage kidney disease are more likely to die from cardiovascular disease than renal dysfunction. However, unlike the general population, patients with CKD are less likely to receive evidence-based optimal medical therapy as well as revascularization therapy including percutaneous coronary intervention or coronary artery bypass graft. Currently, there are no high-quality data to guide the management of coronary artery disease in the CKD population. This chapter discusses the roles of revascularization with percutaneous coronary intervention and coronary artery bypass grafting and further compares their efficacies in patients with CKD based on current evidence in the literature.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 54.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Akerblom A, Wallentin L, Siegbahn A, Becker RC, Budaj A, Buck K, et al. Cystatin C and estimated glomerular filtration rate as predictors for adverse outcome in patients with ST-elevation and non-ST-elevation acute coronary syndromes: results from the platelet inhibition and patient outcomes study. Clin Chem. 2012;58(1):190–9.

    PubMed  Google Scholar 

  2. Chu CY, Lin TH, Lai WT. The management and prognostic factors of acute coronary syndrome: evidence from the Taiwan acute coronary syndrome full Spectrum registry. Acta Cardiol Sin. 2017;33(4):329–38.

    PubMed  PubMed Central  Google Scholar 

  3. Mathew RO, Bangalore S, Lavelle MP, Pellikka PA, Sidhu MS, Boden WE, et al. Diagnosis and management of atherosclerotic cardiovascular disease in chronic kidney disease: a review. Kidney Int. 2017;91(4):797–807.

    PubMed  Google Scholar 

  4. Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, MacGregor JM, et al. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360(24):2503–15.

    CAS  PubMed  Google Scholar 

  5. Washam JB, Herzog CA, Beitelshees AL, Cohen MG, Henry TD, Kapur NK, et al. Pharmacotherapy in chronic kidney disease patients presenting with acute coronary syndrome: a scientific statement from the American Heart Association. Circulation. 2015;131(12):1123–49.

    PubMed  Google Scholar 

  6. Fox CS, Muntner P, Chen AY, Alexander KP, Roe MT, Cannon CP, et al. Use of evidence-based therapies in short-term outcomes of ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in patients with chronic kidney disease: a report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry. Circulation. 2010;121(3):357–65.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Charytan D, Forman JP, Cutlip DE. Risk of target lesion revascularization after coronary stenting in patients with and without chronic kidney disease. Nephrol Dial Transplant. 2007;22(9):2578–85.

    PubMed  Google Scholar 

  8. Gibney EM, Casebeer AW, Schooley LM, Cunningham F, Grover FL, Bell MR, et al. Cardiovascular medication use after coronary bypass surgery in patients with renal dysfunction: a national veterans administration study. Kidney Int. 2005;68(2):826–32.

    PubMed  Google Scholar 

  9. Palmer SC, Di Micco L, Razavian M, Craig JC, Perkovic V, Pellegrini F, et al. Effects of antiplatelet therapy on mortality and cardiovascular and bleeding outcomes in persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;156(6):445–59.

    PubMed  Google Scholar 

  10. Freeman RV, Mehta RH, Al Badr W, Cooper JV, Kline-Rogers E, Eagle KA. Influence of concurrent renal dysfunction on outcomes of patients with acute coronary syndromes and implications of the use of glycoprotein IIb/IIIa inhibitors. J Am Coll Cardiol. 2003;41(5):718–24.

    CAS  PubMed  Google Scholar 

  11. Manske CL, Wilson RF, Wang Y, Thomas W. Prevalence of, and risk factors for, angiographically determined coronary artery disease in type I-diabetic patients with nephropathy. Arch Intern Med. 1992;152(12):2450–5.

    CAS  PubMed  Google Scholar 

  12. Sedlis SP, Jurkovitz CT, Hartigan PM, Goldfarb DS, Lorin JD, Dada M, Maron DJ, Spertus JA, Mancini GB, Teo KK, O’Rourke RA, Boden WE, Weintraub WS. COURAGE study investigators. Optimal medical therapy with or without percutaneous coronary intervention for patients with stable coronary artery disease and chronic kidney disease. Am J Cardiol. 2009;104(12):1647–53.

    PubMed  Google Scholar 

  13. Rigatto C, Komenda P, Tangri N. CABG or PCI: which is better for revascularization of coronary artery disease in chronic kidney disease? Kidney Int. 2016;90(2):257–9.

    PubMed  Google Scholar 

  14. Farkouh ME, Domanski M, Sleeper LA, Siami FS, Dangas G, Mack M, Yang M, Cohen DJ, Rosenberg Y, Solomon SD, Desai AS, Gersh BJ, Magnuson EA, Lansky A, Boineau R, Weinberger J, Ramanathan K, Sousa JE, Rankin J, Bhargava B, Buse J, Hueb W, Smith CR, Muratov V, Bansilal S, King S 3rd, Bertrand M, Fuster V. FREEDOM trial investigators. Strategies for multivessel revascularization in patients with diabetes. N Engl J Med. 2012;367(25):2375–84.

    CAS  PubMed  Google Scholar 

  15. Aziz EF, Pulimi S, Coleman C, Florita C, Musat D, Tormey D, Fawzy A, Lee S, Herzog E, Coven DL, Tamis-Holland J, Hong MK. Increased vascular access complications in patients with renal dysfunction undergoing percutaneous coronary procedures using arteriotomy closure devices. J Invasive Cardiol. 2010;22(1):8–13.

    PubMed  Google Scholar 

  16. Shoukat S, et al. Contrast-Induced Nephropathy in Patients Undergoing Percutaneous Coronary Intervention. Cardiol Res Pract. 2010;2010:649164.

    PubMed  PubMed Central  Google Scholar 

  17. Baim DS, Grossman W. Complications of cardiac catheterization. In: Baim DS, Grossman W, editors. Cardiac Catheterization, Angiography and Intervention. Baltimore: Williams & Wilkins; 1996. p. 17.

    Google Scholar 

  18. Blackman DJ, Pinto R, Ross JR, Seidelin PH, Ing D, Jackevicius C, et al. Impact of renal insufficiency on outcome after contemporary percutaneous coronary intervention. Am Heart J. 2006;151(1):146–52.

    PubMed  Google Scholar 

  19. Volodarskiy A, Kumar S, Pracon R, Sidhu M, Kretov E, Mazurek T, et al. Drug-eluting vs bare-metal stents in patients with chronic kidney disease and coronary artery disease: insights from a systematic review and meta-analysis. J Invasive Cardiol. 2018;30(1):10–7.

    PubMed  Google Scholar 

  20. Lemos PA, Arampatzis CA, Hoye A, Daemen J, Ong AT, Saia F, et al. Impact of baseline renal function on mortality after percutaneous coronary intervention with sirolimus-eluting stents or bare metal stents. Am J Cardiol. 2005;95(2):167–72.

    CAS  PubMed  Google Scholar 

  21. Lu R, Tang F, Zhang Y, Zhu X, Zhu S, Wang G, et al. Comparison of drug-eluting and bare metal stents in patients with chronic kidney disease: an updated systematic review and meta-analysis. J Am Heart Assoc. 2016;7:5(11).

    Google Scholar 

  22. Green SM, Selzer F, Mulukutla SR, Tadajweski EJ, Green JA, Wilensky RL, et al. Comparison of bare-metal and drug-eluting stents in patients with chronic kidney disease (from the NHLBI dynamic registry). Am J Cardiol. 2011;108(11):1658–64.

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Wang WT, Sung SH, Wu CH, Huang SS, Chen WL, Lin SJ, et al. Long-term outcome of patients with very small coronary artery disease: a comparison of drug-eluting and bare metal stents. J Chin Med Assoc. 2016;79(12):642–8.

    PubMed  Google Scholar 

  24. Kaul U, Bangalore S, Seth A, Arambam P, Abhaichand RK, Patel TM, et al. Paclitaxel-eluting versus Everolimus-eluting coronary stents in diabetes. N Engl J Med. 2015;373(18):1709–19.

    CAS  PubMed  Google Scholar 

  25. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351(13):1296–305.

    CAS  PubMed  Google Scholar 

  26. Bhatt DL, Roe MT, Peterson ED, Li Y, Chen AY, Harrington RA, et al. Utilization of early invasive management strategies for high-risk patients with non-ST-segment elevation acute coronary syndromes: results from the CRUSADE quality improvement initiative. JAMA. 2004;292(17):2096–104.

    CAS  PubMed  Google Scholar 

  27. Shaw C, Nitsch D, Lee J, Fogarty D, Sharpe CC. Impact of an early invasive strategy versus conservative strategy for unstable angina and non-ST elevation acute coronary syndrome in patients with chronic kidney disease: a systematic review. PLoS One. 2016;11(5):e0153478.

    PubMed  PubMed Central  Google Scholar 

  28. Young Altahan R, Goldenberg I, Kimron L, Barsheshet A, Guetta V. Timing of coronary angiography and outcome in patients with non-ST elevation acute coronary syndromes and kidney disease: real-world data from the acute coronary syndromes Israeli survey. Cardiology. 2011;119(4):224–34.

    PubMed  Google Scholar 

  29. Patel B, Shah M, Dusaj R, Maynard S, Patel N. Percutaneous coronary intervention and inpatient mortality in patients with advanced chronic kidney disease presenting with acute coronary syndrome. Proc (Bayl Univ Med Cent). 2017;30(4):400–3.

    Google Scholar 

  30. Ix JH, Mercado N, Shlipak MG, Lemos PA, Boersma E, Lindeboom W, et al. Association of chronic kidney disease with clinical outcomes after coronary revascularization: the arterial revascularization therapies study (ARTS). Am Heart J. 2005;149(3):512–9.

    PubMed  Google Scholar 

  31. Aoki J, Ong AT, Hoye A, van Herwerden LA, Sousa JE, Jatene A, et al. Five year clinical effect of coronary stenting and coronary artery bypass grafting in renal insufficient patients with multivessel coronary artery disease: insights from ARTS trial. Eur Heart J. 2005;26(15):1488–93.

    PubMed  Google Scholar 

  32. Garg S, Sarno G, Gutierrez-Chico JL, Garcia-Garcia HM, Gomez-Lara J, Serruys PW. Five-year outcomes of percutaneous coronary intervention compared to bypass surgery in patients with multivessel disease involving the proximal left anterior descending artery: an ARTS-II sub-study. EuroIntervention. 2011;6(9):1060–7.

    PubMed  Google Scholar 

  33. Charytan DM, Desai M, Mathur M, Stern NM, Brooks MM, Krzych LJ, et al. Reduced risk of myocardial infarct and revascularization following coronary artery bypass grafting compared with percutaneous coronary intervention in patients with chronic kidney disease. Kidney Int. 2016;90(2):411–21.

    PubMed  PubMed Central  Google Scholar 

  34. Ashrith G, Lee VV, Elayda MA, Reul RM, Wilson JM. Short- and long-term outcomes of coronary artery bypass grafting or drug-eluting stent implantation for multivessel coronary artery disease in patients with chronic kidney disease. Am J Cardiol. 2010;106(3):348–53.

    PubMed  Google Scholar 

  35. Kang SH, Lee CW, Yun SC, Lee PH, Ahn JM, Park DW, et al. Coronary artery bypass grafting vs. drug-eluting stent implantation for multivessel disease in patients with chronic kidney disease. Korean Circ J. 2017;47(3):354–60.

    PubMed  PubMed Central  Google Scholar 

  36. Bangalore S, Guo Y, Samadashvili Z, Blecker S, Xu J, Hannan EL. Revascularization in patients with multivessel coronary artery disease and chronic kidney disease: Everolimus-eluting stents versus coronary artery bypass graft surgery. J Am Coll Cardiol. 2015;66(11):1209–20.

    PubMed  PubMed Central  Google Scholar 

  37. Cavalcante R, Sotomi Y, Lee CW, Ahn JM, Farooq V, Tateishi H, et al. Outcomes after percutaneous coronary intervention or bypass surgery in patients with unprotected left Main disease. J Am Coll Cardiol. 2016;68(10):999–1009.

    PubMed  Google Scholar 

  38. Inrig JK, Patel UD, Briley LP, She L, Gillespie BS, Easton JD, et al. Mortality, kidney disease and cardiac procedures following acute coronary syndrome. Nephrol Dial Transplant. 2008;23(3):934–40.

    PubMed  Google Scholar 

  39. Levine GN, Bates ER, Bittl JA, Brindis RG, Fihn SD, Fleisher LA, et al. 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. J Thorac Cardiovasc Surg. 2016;152(5):1243–75.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mandeep S. Sidhu .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Wang, S.C., Nichols, E.L., Farkouh, M.E., Sidhu, M.S. (2020). Revascularization Strategies in Chronic Kidney Disease: Percutaneous Coronary Interventions Versus Coronary Artery Bypass Graft. In: Rangaswami, J., Lerma, E., McCullough, P. (eds) Kidney Disease in the Cardiac Catheterization Laboratory . Springer, Cham. https://doi.org/10.1007/978-3-030-45414-2_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-45414-2_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-45413-5

  • Online ISBN: 978-3-030-45414-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics