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Revascularization of complex coronary lesions often faces the dilemma of choosing a treatment strategy
.
Today, percutaneous coronary intervention (PCI) can treat almost all coronary lesions, but for multivessel diffuse disease, left main disease, and anatomical structures that are not suitable for PCI treatment, there is a long operation time, high risk, and success rate.
Revascularization of complex coronary lesions often faces the dilemma of choosing a treatment strategy
Blood vessel
To date, the long-term prognostic impact of mildly reduced renal function in patients undergoing coronary revascularization surgery remains unknown
.
To investigate the long-term prognostic impact of mild decline in renal function, and to compare outcomes after PCI or CABG in such risk groups, researchers from South Korea conducted a study published in the journal JACC
From the Asan Medical Center - Polyvascular Recanalization Registry, 10,354 eligible patients undergoing coronary recanalization were divided into 3 groups based on estimated glomerular filtration rate (Stage I [n = 3735]: Normal renal function; stage II [n = 5122]: mild dysfunction; stage III [n = 1497]: moderate dysfunction)
.
The primary outcome was a composite of death, spontaneous myocardial infarction
myocardial infarction
RESULTS: After propensity matching, the risk of the primary composite outcome did not differ between the stage I and II groups (HR: 1.
12; 95% CI: 0.
97-1.
30)
.
However, the risk of the primary outcome was significantly higher in the stage III group than in the stage I group (HR: 1.
RESULTS: After propensity matching, the risk of the primary composite outcome did not differ between the stage I and II groups (HR: 1.
No difference in outcomes between patients with stage II and stage I renal insufficiency
No difference in outcomes between patients with stage II and stage I renal insufficiencyIn conclusion, in patients with polyvascular disease undergoing revascularization by PCI or CABG, a mild decrease in renal function was not significantly associated with an increased risk of the primary composite outcome and mortality
.
In the marginal-risk group, comparisons after PCI and CABG were similar
In conclusion, in patients with polyvascular disease undergoing revascularization by PCI or CABG, a mild decrease in renal function was not significantly associated with an increased risk of the primary composite outcome and mortality
references:
Prognostic Impact of Mildly Impaired Renal Function in Patients Undergoing Multivessel Coronary Revascularization.
Prognostic Impact of Mildly Impaired Renal Function in Patients Undergoing Multivessel Coronary Revascularization.
J Am Coll Cardiol.
2022 Apr, 79 (13) 1270–1284 Prognostic Impact of Mildly Impaired Renal Function in Patients Undergoing Multivessel Coronary Revascularization.
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