Key result
CKD is linked to ~48% higher MACCE risk in stable ischemic heart disease with diabetes.
Why the study?
The optimal coronary revascularization strategy in patients with stable ischemic heart disease who have type 2 diabetes and chronic kidney disease remains unclear.
Does CABG plus optimal medical therapy reduce MACCE compared to PCI plus optimal medical therapy in patients with stable ischemic heart disease, type 2 diabetes, and chronic kidney disease?
Meta-Analysis (n=4,953)
Yes
Does CABG plus optimal medical therapy reduce MACCE compared to PCI plus optimal medical therapy in patients with stable ischemic heart disease, type 2 diabetes, and chronic kidney disease?
Hazard Ratio: 1.48 (95% CI 1.28–1.71)
p-value: p=0.0001
In patients with stable ischemic heart disease, diabetes, and CKD, CABG plus optimal medical therapy showed a nonsignificant trend toward better MACCE outcomes and significantly reduced subsequent revascularization compared to PCI plus optimal medical therapy.
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Farkouh et al. (2019) conducted a meta-analysis in Stable ischemic heart disease with type 2 diabetes (n=4,953). Chronic kidney disease (CKD) vs. No CKD was evaluated on Composite of major adverse cardiovascular or cerebrovascular events (MACCE) including all-cause death, myocardial infarction (MI), or stroke (HR 1.48, 95% CI 1.28-1.71, p=0.0001). In patients with stable ischemic heart disease and type 2 diabetes, chronic kidney disease was associated with an increased risk of MACCE (HR 1.48; 95% CI 1.28-1.71; p=0.0001).
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