Coronary angiography or revascularization in advanced CKD and CCS does not improve outcomes: Study

The results of the study are as follows:

• Compared with those not listed, listed patients were younger (60 years vs 65 years), were less likely to be of Asian race (15% vs 29%), were more likely to be on dialysis (83% vs 44%), had fewer anginal symptoms, and were more likely to have coronary angiography and coronary revascularization irrespective of treatment assignment.
• Among patients assigned to an invasive strategy versus conservative strategy, the adjusted hazard ratios for the primary outcome were 0.91 for those listed and not listed, respectively.
• Adjusted hazard ratios for secondary outcomes were 0.89 in listed and 1.17 in those not listed.

The researchers concluded that in ISCHEMIA-CKD, an invasive strategy in kidney transplant candidates did not improve outcomes compared with conservative management. These data do not support routine coronary angiography or revascularization in patients with advanced CKD and chronic coronary syndromes listed for transplant.

Reference:

Kidney Transplant List Status and Outcomes in the ISCHEMIA-CKD Trial by Herzog C et. al published in the Journal of the American College of Cardiology.

Doi: 10.1016/j.jacc.2021.05.001