Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12080
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dc.contributor.authorSugumar, Hariharanen
dc.contributor.authorLancefield, Terase Fen
dc.contributor.authorAndrianopoulos, Nicken
dc.contributor.authorDuffy, Stephen Jen
dc.contributor.authorAjani, Andrew Een
dc.contributor.authorFreeman, Melanieen
dc.contributor.authorBuxton, Brian Fen
dc.contributor.authorBrennan, Angela Len
dc.contributor.authorYan, Bryan Pen
dc.contributor.authorDinh, Diem Ten
dc.contributor.authorSmith, Julian Aen
dc.contributor.authorCharter, Kerrieen
dc.contributor.authorFarouque, Omaren
dc.contributor.authorReid, Christopher Men
dc.contributor.authorClark, David Jen
dc.date.accessioned2015-05-16T01:43:36Z
dc.date.available2015-05-16T01:43:36Z
dc.date.issued2014-01-24en
dc.identifier.citationInternational Journal of Cardiology 2014; 172(2): 442-9en
dc.identifier.govdoc24521692en
dc.identifier.otherPUBMEDen
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/12080en
dc.description.abstractComorbidities, such as diabetes, affect revascularization strategy for coronary disease. We sought to determine if the degree of renal impairment affected long-term mortality after percutaneous coronary intervention (PCI) compared to coronary artery bypass grafting (CABG) in patients with multi-vessel coronary disease (MVD).8970 patients with MVD undergoing revascularization between 2004 and 2008, in two multi-center parallel PCI and CABG Australian registries were assigned to three groups based on their estimated glomerular filtration rate (eGFR)≥60 mL/min/1.73 m2 (n=1678:839), 30-59 mL/min/1.73 m2 (n=452:226) and <30 mL/min/1.73 m2 (n=74:37). We used 2:1 propensity matching to compare 3306 patients undergoing primary CABG versus PCI. Shock, myocardial infarction (MI)<24 h, previous CABG, valve surgery or PCI were exclusions. Long-term mortality (mean 3.1 years) was compared with Cox-proportional hazard-adjusted modeling. Observed long-term mortality rates (CABG vs. PCI) were 4.5% vs. 4.3% p=0.84, 12.8% vs. 17.3% p=0.12, and 23.0% vs. 40.5% p=0.05 in the three strata, respectively. In patients with eGFR≥60 mL/min/1.73 m2, long-term mortality between PCI and CABG (HR 0.99, 95% CI 0.65-1.49, p=0.95) was similar. However, amongst patients with eGFR 30-59 mL/min/1.73 m2, there was a significant mortality hazard with PCI (HR 2.00, 95% CI 1.32-3.04, p=0.001). In patients with eGFR<30 mL/min/1.73 m2, there was a trend for hazard with PCI (HR 1.66, 95% CI 0.80-3.46, p=0.17).Long-term mortality in MVD patients with preserved renal function was very low and similar between PCI and CABG. However there was a long-term mortality hazard associated with PCI amongst patients with moderate renal impairment.en
dc.language.isoenen
dc.subject.otherAngioplastyen
dc.subject.otherCoronary diseaseen
dc.subject.otherKidneyen
dc.subject.otherRevascularizationen
dc.subject.otherSurgeryen
dc.subject.otherAgeden
dc.subject.otherAustralia.epidemiologyen
dc.subject.otherComorbidityen
dc.subject.otherCoronary Artery Bypass.mortalityen
dc.subject.otherCoronary Disease.mortality.surgeryen
dc.subject.otherFemaleen
dc.subject.otherGlomerular Filtration Rateen
dc.subject.otherHumansen
dc.subject.otherKidney Diseases.mortalityen
dc.subject.otherKidney Function Testsen
dc.subject.otherMaleen
dc.subject.otherMiddle Ageden
dc.subject.otherNew Zealand.epidemiologyen
dc.subject.otherPercutaneous Coronary Intervention.mortalityen
dc.subject.otherRegistriesen
dc.titleImpact of renal function in patients with multi-vessel coronary disease on long-term mortality following coronary artery bypass grafting compared with percutaneous coronary intervention.en
dc.typeJournal Articleen
dc.identifier.journaltitleInternational journal of cardiologyen
dc.identifier.affiliationDepartment of Cardiology, Royal Melbourne Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationElectronic address: clarkdavidj@hotmail.com.en
dc.identifier.affiliationDepartment of Cardiothoracic Surgery, Monash Medical Centre, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Surgery, University of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.affiliationUniversity of Melbourne, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Surgery, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong; Department of Cardiology, Prince of Wales Hospital, Hong Kong, China.en
dc.identifier.affiliationDepartment of Cardiac Surgery, Austin Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationCentre of Cardiovascular Research and Education in Therapeutics (CCRE), Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Cardiology, Alfred Hospital, Melbourne, Victoria, Australiaen
dc.identifier.affiliationDepartment of Cardiology, Austin Hospital, Melbourne, Victoria, Australiaen
dc.identifier.doi10.1016/j.ijcard.2014.01.096en
dc.description.pages442-9en
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pubmed/24521692en
dc.contributor.corpauthorAustralia and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) & Melbourne Interventional Group (MIG)en
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