Survival outcomes and adverse events in patients with chronic kidney disease after coronary artery bypass grafting and percutaneous coronary intervention: a meta-analysis of propensity score-matching studies

Figures & data

Figure 1. Flow diagram of study selection. CKD: chronic kidney disease.

Table 1. Characteristics of included studies.

Study	Country	Study type	Sample size		Patients on dialysis (%)		Follow-up (years)	Quality of study
			PCI	CABG	PCI	CABG
Baek et al. [15]	Republic of Korea	Cohort study	44	43	100	100	5	7
Bangalore et al. [16]	USA	Cohort study	2960	2960	8.2	8.2	5	8
Chan et al. [17]	USA	Cohort study	893	893	6.2	6.3	2	7
Kilic et al. [18]	USA	Cohort study	352	352	11.1	10.2	5	7
Komiya et al. [19]	Japan	Cohort study	77	77	0	0	4	8
Kumada et al. [20]	Japan	Cohort study	787	210	100	100	10	7
Kumada et al. [21]	Japan	Cohort study	92	92	100	100	5	7
Lautamäki et al. [22]	Finland	Cohort study	54	54	11.1	16.7	3	7
Marui et al. [23]	Japan	Cohort study	258	130	100	100	5	7
Roberts et al. [24]	USA	Cohort study	39	30	1.4	2.1	5	8
Sugumar et al. [25]	Australia	Cohort study	263	526	23	35	3.1	7
Chang et al. [26]	USA	Cohort study	1458	1458	n	n	8	7
Vuurmans et al. [27]	Canada	Cohort study	135	135	n	n	2	7

PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery.

Figure 2. Hazard ratios of overall long-term mortality between PCI and CABG in patients with chronic kidney disease. PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery; SE: standard error; CI: confidence interval.

Figure 3. Hazard ratios of overall long-term mortality between PCI and CABG in patients on dialysis. PCI: percutaneous coronary intervention. CABG: coronary artery bypass surgery; SE: standard error; CI: confidence interval.

Figure 4. Hazard ratios of overall long-term mortality between CABG and PCI in patients with eGFR < 30 and eGFR > 30. PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery; eGFR: estimated glomerular filtration rate; SE: standard error; CI: confidence interval.

Figure 5. Hazard ratios for overall long-term mortality between CABG and PCI in patients with eGFR < 45 and eGFR > 45. PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery; eGFR: estimated glomerular filtration rate; SE: standard error; CI: confidence interval.

Figure 6. Comparison of secondary outcomes (myocardial infarction (MI), revascularization, and stroke) between CABG and PCI in patients with chronic kidney disease. PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery; CI: confidence interval.

Figure 7. Secondary outcomes (myocardial infarction (MI), revascularization, and stroke) between CABG and PCI in patients on dialysis. PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery; CI: confidence interval.

Table 2. Results of the main analysis.

Outcomes	Reported study number	OR/HR with 95% CI	p Value	I^2 (%)
Patients with CKD (CABG vs. PCI)
Mortality risk (HR)
Full cohort	12	0.76 (0.70–0.83)	<.001	21
eGFR 0–30	2	0.56 (0.41–0.77)	<.001	0
eGFR 30–59	4	0.75 (0.63–0.89)	<.001	34
eGFR 0–45	3	0.73 (0.55–0.97)	.03	69
eGFR 45–59	3	0.85 (0.73–0.99)	.04	0
MI (OR)	7	0.25 (0.12–0.54)	<.001	78
Revascularization (OR)	7	0.17 (0.08–0.35)	<.001	87
Stroke (OR)	7	1.24 (0.89–1.73)	>.05	27
Patients on dialysis
Mortality risk (HR)	6	0.74 (0.60–0.91)	.005	24
MI (OR)	3	0.46 (0.30–0.72)	<.001	0
Revascularization (OR)	3	0.30 (0.18–0.51)	<.001	44
Stroke (OR)	3	0.97 (0.47–2.00)	p > .05	33

OR: odd ratio; HR: hazard ratio; CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; PCI: percutaneous coronary intervention; CABG: coronary artery bypass surgery.

Figure 8. Funnel plot for the survival hazard ratio.

Figure 9. Funnel plot for odds ratios for myocardial infarction (MI), revascularization, and stroke.

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Data availability statement

All data and materials used in this research are freely available. References have been provided.