Paul, TK, Mamas, MA, Shanmugasundaram, M, Nagarajarao, HS, Ojha, CP, Jneid, H, Kumar, G and White, CJ (2021) Medical Therapy Versus Revascularization in Patients with Stable Ischemic Heart Disease and Advanced Chronic Kidney Disease. Curr Cardiol Rep, 23 (4). 23 - ?.

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PURPOSE OF REVIEW: This 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 FINDINGS: A 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. An initial revascularization strategy does not reduce mortality or MI or relieve angina symptoms in patients with SIHD and advanced CKD.

Item Type: Article
Uncontrolled Keywords: Coronary Artery Disease; chronic kidney disease; CKD; renal impairment
Subjects: R Medicine > RC Internal medicine > RC666 Diseases of the circulatory (Cardiovascular) system
R Medicine > RC Internal medicine > RC902 Nephrology
Divisions: Faculty of Medicine and Health Sciences > School of Primary, Community and Social Care
Related URLs:
Depositing User: Symplectic
Date Deposited: 05 May 2023 11:25
Last Modified: 05 May 2023 11:25

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