Surgical versus interventional coronary revascularization in kidney transplant recipients: a systematic review and meta-analysis

Abstract

Abstract Aim To study the most beneficial coronary revascularization strategy in kidney transplant recipients (KTR). Methods In 16th June 2022 and updated on 26th February 2023, we searched in five databases including PubMed for relevant articles. The odds ratio (OR) together with the 95% confidence interval (95%CI) were used to report the results. Results Percutaneous coronary intervention (PCI) was significantly associated with significant lower in-hospital mortality (OR 0.62; 95%CI 0.51–0.75) and 1-year mortality (OR 0.81; 95%CI 0.68–0.97), but not overall mortality (mortality at the last follow-up point) (OR 1.05; 95%CI 0.93–1.18) rather than coronary artery bypass graft (CABG). Moreover, PCI was significantly associated with lower acute kidney injury prevalence (OR 0.33; 95%CI 0.13–0.84) compared to CABG. One study indicated that non-fatal graft failure prevalence did not differ between the PCI and the CABG group until 3 years of follow up. Moreover, one study demonstrated a short hospital length of stay in the PCI group rather than the CABG group. Conclusion Current evidence indicated the superiority of PCI than CABG as a coronary revascularization procedure in short- but not long-term outcomes in KTR. We recommend further randomized clinical trials for demonstrating the best therapeutic modality for coronary revascularization in KTR.