Document Detail


Management and outcomes of renal disease and acute myocardial infarction.
MedLine Citation:
PMID:  20800154     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Contemporary trends in the management and outcomes of chronic kidney disease patients who develop an acute myocardial infarction have not been adequately described, particularly from the more generalizable perspective of a population-based investigation.
METHODS: The study population consisted of 6219 residents of the Worcester, Massachusetts, metropolitan area who were hospitalized with acute myocardial infarction in 6 annual periods between 1995 and 2005. Patients were categorized as having preserved kidney function (n=3154), mild to moderate chronic kidney disease (n=2313), or severe chronic kidney disease (n=752) at the time of hospital admission.
RESULTS: Patients with chronic kidney disease were more likely to be older, to have a greater prevalence of comorbidities, and to experience significant in-hospital complications or die during hospitalization in comparison with patients with preserved kidney function. Although patients with chronic kidney disease were less likely to receive effective cardiac medications or undergo coronary interventional procedures than patients without kidney disease, we observed a marked increase in the use of effective cardiac medications and coronary interventional procedures in patients with chronic kidney disease during the period under study. In-hospital death rates declined over time among patients with chronic kidney disease, whereas these death rates remained unchanged among persons with normal kidney function.
CONCLUSION: The results of this study in residents of a large New England metropolitan area provide insights into changing trends in the treatment and impact of chronic kidney disease in patients hospitalized with acute myocardial infarction.
Authors:
Paul A Santolucito; Dennis A Tighe; David D McManus; Jorge Yarzebski; Darleen Lessard; Joel M Gore; Robert J Goldberg
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The American journal of medicine     Volume:  123     ISSN:  1555-7162     ISO Abbreviation:  Am. J. Med.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-09-13     Revised Date:  2011-09-13    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  847-55     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary
Biological Markers / blood
Blood Pressure
Cardiovascular Agents / therapeutic use
Chronic Disease
Coronary Angiography
Coronary Artery Bypass
Creatinine / blood
Drug Prescriptions / statistics & numerical data
Female
Glomerular Filtration Rate*
Heart Rate
Humans
Kidney Diseases / complications*,  physiopathology*,  therapy
Length of Stay
Male
Massachusetts / epidemiology
Middle Aged
Myocardial Infarction / complications*,  drug therapy,  epidemiology,  physiopathology,  surgery,  therapy*
Physician's Practice Patterns / trends*
Prevalence
Research Design
Retrospective Studies
Grant Support
ID/Acronym/Agency:
R01 HL035434-26A1/HL/NHLBI NIH HHS; R01 HL35434/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Cardiovascular Agents; 60-27-5/Creatinine
Comments/Corrections

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