{"id":"36686aa1e3ff","type":"article","url":"https://hartvaat.nl/2016/08/01/cabg-versus-pci-en-risico-op-myocardinfarct-en-revascularisatie-bij-ckd-patiente/","title":"CABG versus PCI en risico op myocardinfarct en revascularisatie bij CKD-patiënten","title_en":"Reduced risk of myocardial infarct and revascularization following coronary artery bypass grafting compared with percutaneous coronary intervention in patients with chronic kidney disease.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":["coronaire-bypass","myocardinfarct"],"journal":"Kidney international","doi":"10.1016/j.kint.2016.03.033","source_url":"https://doi.org/10.1016/j.kint.2016.03.033","authors":["David M Charytan","Manisha Desai","Maya Mathur","Noam M Stern","Maria M Brooks","Lukasz J Krzych","Gerhard C Schuler","Jan Kaehler","Alfredo M Rodriguez-Granillo","Whady Hueb","Barnaby C Reeves","Holger Thiele","Alfredo E Rodriguez","Piotr P Buszman","Paweł E Buszman","Rie Maurer","Wolfgang C Winkelmayer"],"significance":6,"published":"2016-08-01","source_date":"2016-08-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/nierziekte/nsaids-en-nierziekte/"],"congress":"","summary_en":"This study compared the risk of MI and revascularization after CABG versus PCI in patients with chronic kidney disease, showing that CABG provides superior protection against recurrent coronary events in this high-risk renal population.","created":"2026-07-03T10:26:15Z","updated":"2026-07-03T13:25:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die het risico op myocardinfarct en herrevascularisatie vergeleek na CABG versus PCI bij patiënten met chronische nierziekte. Relevant voor revascularisatiebeslissingen bij deze hoogrisicopopulatie.","abstract_original":"Coronary atherosclerotic disease is highly prevalent in chronic kidney disease (CKD). Although revascularization improves outcomes, procedural risks are increased in CKD, and unbiased data comparing coronary artery bypass grafting (CABG) and percutaneous intervention (PCI) in CKD are sparse. To compare outcomes of CABG and PCI in stage 3 to 5 CKD, we identified randomized trials comparing these procedures. Investigators were contacted to obtain individual, patient-level data. Ten of 27 trials meeting inclusion criteria provided data. These trials enrolled 3993 patients encompassing 526 patients with stage 3 to 5 CKD of whom 137 were stage 3b-5 CKD. Among individuals with stage 3 to 5 CKD, mortality through 5 years was not different after CABG compared with PCI (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.67-1.46) or stage 3b-5 CKD (HR 1.29, CI 0.68-2.46). However, CKD modified the impact on survival free of myocardial infarction: it was not different between CABG and PCI for individuals with preserved kidney function (HR 0.97, CI 0.80-1.17), but was significantly lower after CABG in stage 3-5 CKD (HR 0.49, CI 0.29-0.82) and stage 3b-5 CKD (HR 0.23, CI 0.09-0.58). Repeat revascularization was reduced after CABG compared with PCI regardless, of baseline kidney function. Results were limited by unavailability of data from several trials and paucity of enrolled patients with stage 4-5 CKD. Thus, our patient-level meta-analysis of individuals with CKD randomized to CABG versus PCI suggests that CABG significantly reduces the risk of subsequent myocardial infarction and revascularization without affecting survival in these patients."}