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Renal Function and Effect of Statin Therapy on Cardiovascular Outcomes in Patients Undergoing Coronary Revascularization (from the CREDO-Kyoto PCI/CABG Registry Cohort-2)
Although statin therapy is essential for secondary cardiovascular prevention, the therapeutic effect of statins on cardiovascular outcomes in patients with advanced chronic kidney disease (CKD) after coronary revascularization has not been fully elucidated. In the CREDO-Kyoto Registry Cohort-2, 14,706 patients who underwent first coronary revascularization were divided into 4 strata based on estimated glomerular filtration rate (eGFR) or status of hemodialysis (HD). Patients in each stratum were further divided into 2 groups based on statin therapy at discharge: non-CKD stratum (eGFR ≥60 ml/min/1.73 m2), 8,959 patients (statin, n = 4,747; no statin, n = 4,212); mild CKD stratum (eGFR ≥30 to <60 ml/min/1.73 m2), 4,567 patients (statin, n = 2,135; no statin, n = 2,432); severe CKD stratum (eGFR <30 ml/min/1.73 m2), 608 patients (statin, n = 229; no statin, n = 379); and HD stratum, 572 patients (statin, n = 117; no statin, n = 455).Comparison of Long-Term Outcome After Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Unprotected Left Main Coronary Artery Disease (from the CREDO-Kyoto PCI/CABG Registry Cohort-2)
The long-term outcome of percutaneous coronary intervention (PCI) compared to coronary artery bypass grafting (CABG) for unprotected left main coronary artery disease (ULMCAD) remains to be investigated. We identified 1,005 patients with ULMCAD of 15,939 patients with first coronary revascularization enrolled in the CREDO-Kyoto PCI/CABG Registry Cohort-2. Cumulative 3-year incidence of a composite of death/myocardial infarction (MI)/stroke was significantly higher in the PCI group than in the CABG group (22.7% vs 14.8%, p = 0.0006, log-rank test).
