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Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients with Coronary Artery Disease and Diabetic Nephropathy: A Single Center Experience

Authors
 Ki Sun Bae  ;  Hyeong Cheon Park  ;  Sung Kyu Ha  ;  You Sun Hong  ;  Young Won Yoon  ;  Kyung Jin Oh  ;  Nu Ri Chon  ;  Jong Won Park  ;  Byung Seung Kang 
Citation
 Korean Journal of Medicine, Vol.22(3) : 139-146, 2007 
Journal Title
 Korean Journal of Medicine 
ISSN
 1738-9364 
Issue Date
2007
Abstract
Background Patients with diabetic nephropathy (DN) and coronary artery disease (CAD) represent a subset of patients with high cardiovascular morbidity and mortality. The optimal revascularization strategy using either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) remains controversial. The purpose of this study was to compare the clinical outcomes of PCI to CABG in DN patients with CAD. Methods The clinical and angiographic records of DN patients with CAD who underwent either CABG (n=52) or PCI (n=48) were retrospectively analyzed. Results The baseline characteristics were similar in the two groups except for the severity of the CAD. At 30 days, the death rate (PCI: 2.1% vs. CABG: 9.6%, p=0.21) and major adverse cardiac events (MACE) rate (PCI: 2.1% vs. CABG: 9.6%, p=0.21) were similar in comparisons between the PCI and CABG groups. At three years, the death rate (PCI: 18.8% vs. CABG: 19.2%, p=0.94) was similar between the PCI and CABG groups but the MACE rate (PCI: 47.9% vs. CABG: 21.2%, p=0.006) was higher in the PCI group compared to the CABG group. In addition, the repeat revascularization rate was higher in the PCI group compared to the CABG group (PCI: 12.5% vs. CABG: 1.9%, p=0.046). Conclusions The CABG procedure was associated with a lower incidence of MACE and repeat revascularization for up to three years of follow-up in DN patients with CAD. However, the overall survival rate was similar in the CABG and PCI groups. Therefore, CABG may be superior to PCI with regard to MACE and repeat revascularization.
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DOI
10.3904/kjim.2007.22.3.139
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
강병승(Kang, Byung Seung)
박형천(Park, Hyeong Cheon) ORCID logo https://orcid.org/0000-0002-1550-0812
배기선(Bae, Ki Sun)
윤영원(Yoon, Young Won) ORCID logo https://orcid.org/0000-0002-0907-0350
하성규(Ha, Sung Kyu)
홍유선(Hong, You Sun)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/97660
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