Percutaneous coronary intervention has better in-hospital outcomes in severe renal failure patients

Abstract

Background: In patients with severe renal failure, coronary artery bypass surgery (CABG) was found to have better long-term outcomes than percutaneous coronary intervention (PCI). This study aims to provide a retrospective analysis of short-term in-hospital peri-operative outcomes between PCI and CABG in patients with severe renal failure. Methods: Patients who underwent CABG and PCI in Q4 2015-2020 were identified in National Inpatient Sample (NIS) database. Patients of age<40 were excluded for congenital heart defects. Patients with comorbidity of severe renal failure were included. Between patients undergoing PCI and CABG, preoperative variables were compared and corrected in multivariable logistic regression examining their in-hospital peri-operative outcomes. Adjusted odds ratios (aOR) were estimated for mortality and morbidities. Results: In NIS, 4,512 CABG and 13,242 PCI cases were identified. Compared to CABG, patients who underwent PCI had lower mortality (4.24% vs 5.47%, aOR 0.725, p<0.0001) and lower morbidity including heart failure (0.14% vs 2.97%, aOR 0.044, p<0.0001), stroke (0.12% vs 0.47%, aOR 0.264, p<0.0001), respiratory complications (0.51% vs 7.34%, aOR 0.063, p<0.0001), renal complications (0.05% vs 0.49%, aOR 0.075, p<0.0001), acute kidney injury (8.67% vs 12.66%, aOR 0.646, p<0.0001), deep wound complications (0.02% vs 0.35%, aOR 0.042, p < 0.0001), shock (0.22% vs 0.95%, aOR 0.228, p<0.0001), and length of in-hospital stay over 7 days (24.75% vs 73.52%, aOR 0.106, p<0.0001). Conclusion: NIS is a comprehensive database of nationwide providers, providing robust power in analysis. In patients with severe renal failure, PCI offers an advantage over CABG in terms of short-term in-hospital perioperative outcomes.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

This study did not receive any funding

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethics committee/IRB of The George Washington University School of Medicine and Health Sciences waived ethical approval for this work

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Yes

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I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

Data Availability

All data produced in the present study are available upon reasonable request to the authors.

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