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The researchers concluded in a recent study that the success of cardiovascular therapies, whether medical or surgical, can be influenced by the level of risk of cardiovascular disease in a patient with chronic kidney disease.
"The results badociated with cardiovascular treatments in patients with chronic kidney disease differed according to the initial cardiovascular risk," David M. Charytan, MARYLAND, Brigham & Women's Hospital, and his colleagues wrote.
Previous studies comparing the success of medical treatment with percutaneous coronary intervention (PCI) or surgery, such as coronary artery bypbad surgery (CABG) in patients with coronary heart disease suffering from cardiovascular disease "n & # 39, have evaluated the progression of renal failure, "wrote the investigators." We compared separately the risks of renal failure and death after treatment with PCI, PAC or optimization of medical treatment of coronary heart disease in patients with chronic nephropathy patients stratified according to the risk of cardiovascular disease. "
The retrospective cohort study included 34,385 individuals with chronic kidney disease from a national sample who underwent angiography or a diagnostic stress test without cardiovascular disease (low risk) or prior (medium risk) or with acute coronary syndrome ( high risk).
The researchers evaluated the results according to the death or progression of renal failure in the study group.
The success of cardiovascular treatments, whether medical or surgical, can be influenced by the level of risk of cardiovascular disease in a patient with chronic kidney disease.
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Of the low-risk patients, 960 had PCI, 391 had PAC, and 6,426 received medical treatment alone. Of the medium-risk patients, 1,812 had PCI, 512 had CAM, and 9,984 received medical treatment alone. Of the high-risk patients, 4,608 had PCI, 1,330 had CAP, and 8,362 received medical treatment alone.
The results showed that in low and medium risk patients, neither PACs nor PCIs were badociated with reduced mortality compared to medical treatment, but in low risk patients, PACs were badociated with a higher rate of death or kidney failure. "Coronary revascularization was not badociated with improved survival in low-risk patients, but was badociated with improved survival in high-risk patients despite a higher rate of renal failure." observed, "the researchers wrote.
"These findings can inform clinical decision-making in the care of patients with chronic kidney disease and cardiovascular disease." – bthere Mark E. Neumann
Disclosure: The study was funded by the National Institutes of Health (grant number HL118314-01). Charytan reports Amgen consulting revenues and fees from Astra Zeneca and Janssen. Other authors have no relevant financial information.
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