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Assessing the Economic Attractiveness of Coronary Artery Revascularization in Chronic Kidney Disease Patients

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Abstract

Chronic kidney disease (CKD) is associated with increased morbidity and mortality in coronary artery disease (CAD) patients. We compared the economic attractiveness of CAD revascularization procedures in patients with and without CKD. Our population included 6218 patients with significant CAD undergoing cardiac catheterization at Duke University between 1996 and 2001, with follow-up through 2002. We investigated the influence of CKD (creatinine clearance < 60 mL/min) upon 3-year survival and medical costs in our CAD population. Coronary artery bypass graft (CABG) surgery was an economically attractive alternative vs. percutaneous coronary intervention (PCI) or medical therapy for all patients with left main disease, three-vessel CAD patients without CKD, and two-vessel CAD patients with CKD. Medical therapy was an economically attractive strategy vs. CABG surgery or PCI for three-vessel CAD patients with CKD, two-vessel CAD patients without CKD, and all single-vessel CAD patients.

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Acknowledgment

This study was supported by National Institute of Diabetes and Digestive and Kidney Diseases grant RO1-DK058188. The authors acknowledge the editorial and technical support of Maqui Ortiz.

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Authors and Affiliations

  1. Duke University Medical Center, Durham, NC, USA

    Eric L. Eisenstein, Jie L. Sun, Kevin J. Anstrom, Elizabeth R. DeLong, Lynda A. Szczech & Daniel B. Mark

  2. Duke Clinical Research Institute, P.O. Box 17969, Durham, NC, 27715, USA

    Eric L. Eisenstein, Jie L. Sun, Kevin J. Anstrom, Elizabeth R. DeLong, Lynda A. Szczech & Daniel B. Mark

  3. 2400 Pratt Street, Room 0311, Durham, NC, 27705, USA

    Eric L. Eisenstein

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  1. Eric L. Eisenstein
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  2. Jie L. Sun
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  5. Lynda A. Szczech
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Correspondence to Eric L. Eisenstein.

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Eisenstein, E.L., Sun, J.L., Anstrom, K.J. et al. Assessing the Economic Attractiveness of Coronary Artery Revascularization in Chronic Kidney Disease Patients. J Med Syst 33, 287–297 (2009). https://doi.org/10.1007/s10916-008-9190-4

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  • DOI: https://doi.org/10.1007/s10916-008-9190-4

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