Objective:To compare the clinical results and long-term prognosis of CABG in coronary heart disease(CAD)patients with end-stage renal disease(ESRD)and chronic kidney disease(CKD).Methods:The clinical data of 514 CAD patients combined with ESRD or CKD were collected from January 2017to June 2023,including 72 patients received dialysis treatment before operation and 442 patients with CKD(eGFR ≤ 60 mL·min·-1.73m-2).The perioperative and long-term follow-up results were completed.The primary end point is all-caused death,and the secondary end points include major cardiovascular and cerebrovascular events(MACCE),stroke,angina,myocardial infarction and recharge in-hospital.Results:The in-hospital mortality rates of the ESRD and CKD groups were 6.9％and 2.5％respectively,without statistically significant difference(P＞0.05).The incidence of reoperation for bleeding and perioperative MI in ESRD patients was higher than those in CKD patients(8.3％vs.2.9％,P=0.037;13.9％vs.6.3％,P=0.047),and the incidence of new-onset atrial fibrillation was also higher in ESRD patients(26.4％vs.15.4％,P=0.027).The usage of intra-aortic balloon pump(IABP was higher in ESRD patients(16.7％vs.8.4％,P=0.048),and the support time of ventilator was also higher[(56.3±23.0)vs.(38.5±16.1)h,P=0.007]in the ESRD group.During the follow-up,the incidence of MACCE in the ESRD group was higher than that in the CKD group(30.6％vs.18.6％,P=0.041),and the rates of recurrence of angina and stroke were also higher than those in the CKD group(20.3％vs.10.1％,P=0.028;9.7％vs.3.5％,P=0.040).There was no statistical difference in the long-term survival rate between the two groups(82.3％vs.89.3％,P=0.133).Conclusions:For the CAD patients received dialysis or combined with chronic renal insufficiency,the in-hospital mortality and long-term survival rate were comparable in both groups.The incidence of perioperative complications and follow-up MACCEs in ESRD patients are higher than those in patients with CKD.
维普
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