Long-term outcome of percutaneous transluminal coronary angioplasty and coronary artery bypass grafting in patients with end-stage renal disease

This study was conducted to investigate therapeutic methods for end-stage r enal disease (ESRD) by retrospectively analyzing in-hospital outcome and lo ng-term outcome in patients who underwent either percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafting (CABG). Nine ty-two patients underwent PTCA and 47 underwent CABG, and the initial succe ss rates were 87% and 85%, respectively. As major in-hospital complications , in the PTCA group I died (1%), 2 required emergency CABG (2%), and 2 had Q-wave myocardial infarction (2%); in the CABG group, 7 died (15%) and 3 ha d Q-wave myocardial infarction (6%). As for the long-term outcome, although then were no differences in the incidence of death or the incidence of car diac death between the 2 groups, the cumulative proportion of patients free of death, myocardial infarction, CABG and repeat PTCA was lower in the PTC A group, which was mainly due to a higher incidence of repeat PTCA in that group. The incidence of cardiac death was low for both groups among the pat ients attaining complete revascularization. Twenty-three percent of the pat ients required cross-over implementation of PTCA and CABG. In conclusion, i t is necessary to aim for complete revascularization using both treatments for a better prognosis in patients with ESRD.