Medical Therapy Versus Revascularization in Patients with Stable Ischemic Heart Disease and Advanced Chronic Kidney Disease Article

Full Text via DOI: 10.1007/s11886-021-01453-y Web of Science: 000625341100001
International Collaboration

Cited authors

  • Paul TK, Mamas MA, Shanmugasundaram M, Nagarajarao HS, Ojha CP, Jneid H, Kumar G, White CJ

Abstract

  • Purpose of ReviewThis article reviews the evidence on optimal medical therapy (OMT) versus coronary revascularization in patients with stable ischemic heart disease (SIHD) and advanced chronic kidney disease (CKD).Recent FindingsA post hoc analysis of the COURAGE trial in patients with SIHD and CKD showed no difference in freedom from angina, death, and nonfatal myocardial infarction (MI) between OMT and percutaneous intervention plus OMT compared with patients without CKD. The ISCHEMIA-CKD trial of 777 patients with advanced CKD revealed no difference in cumulative incidence of death or nonfatal MI at 3 years between OMT and revascularization but the composite of death or new dialysis was higher in the invasive arm. Additionally, there were no significant or sustained benefits in related to angina-related health status in invasive versus conservative strategy.SummaryAn initial revascularization strategy does not reduce mortality or MI or relieve angina symptoms in patients with SIHD and advanced CKD.

Authors

Publication date

  • 2021

Published in

International Standard Serial Number (ISSN)

  • 1523-3782

Number of pages

  • 7

Volume

  • 23

Issue

  • 4