Home Messages: CABG vs. PCI in Patients with TVD and CKD

Home Messages: CABG vs. PCI in Patients with TVD and CKD

• CABG remains the gold standard for revascularization in patients with three-vessel coronary artery disease (TVD) and chronic kidney disease (CKD).

• Long-term outcomes favor CABG over PCI, with significantly lower all-cause mortality (68.9% vs. 83.1%), fewer readmissions for MI (10.2% vs. 28.4%), and less need for repeat revascularization (3.1% vs. 24.4%).

• Stroke and all-cause rehospitalization rates were similar between CABG and PCI.

• Despite CABG’s superiority, patient selection remains key—multidisciplinary heart teams should evaluate each case individually.

• With increasing evidence favoring CABG, more CKD patients are expected to undergo surgical revascularization, necessitating strategies to reduce perioperative complications and renal dysfunction.

• Further research is needed, but current evidence strongly supports CABG as the preferred approach for most patients with TVD and CKD.