Document Detail

Renal function, atherothrombosis extent, and outcomes in high-risk patients.
MedLine Citation:
PMID:  19540404     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although prior data showed an association between chronic kidney disease (CKD) and atherothrombotic events, little is known about the risk profile and specific outcomes of atherothrombotic outpatients with CKD. METHODS: More than 69,000 outpatients at risk of atherothrombotic events were enrolled in the REACH Registry. Creatinine clearance (CrCl) was available for 51,208 patients divided into 4 groups: normal (CrCl > or =90 mL/min, n = 13,949), mild (60-89 mL/min, n = 19,474), moderate (30-59 mL/min, n = 15,883), and severe CKD (CrCl <30 mL/min, n = 1902). Baseline characteristics, number of arterial beds overtly affected, medications, overall mortality, cardiovascular death, myocardial infarction, stroke, congestive heart failure, peripheral arterial events, and bleeding events were assessed according to renal function. RESULTS: The number of arterial beds affected increased with severity of CKD. However, patients with severe CKD were less likely to receive medications of proven benefit. Severe CKD was an independent correlate of all-cause mortality, cardiovascular mortality, myocardial infarction, congestive heart failure, peripheral arterial revascularization, or amputation. CONCLUSION: One third of outpatients at risk for atherothrombotic events have moderate to severe CKD. They are less likely to receive beneficial therapies despite a higher atherothrombotic burden and worse outcomes.
Raphaelle L Dumaine; Gilles Montalescot; Ph Gabriel Steg; E Magnus Ohman; Kim Eagle; Deepak L Bhatt;
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  158     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-07-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  141-148.e1     Citation Subset:  AIM; IM    
Pitié-Salpêtrière University Hospital, Paris, France.
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MeSH Terms
Aged, 80 and over
Amputation / statistics & numerical data
Arterial Occlusive Diseases / diagnosis,  epidemiology,  mortality
Atherosclerosis / diagnosis,  epidemiology*,  mortality
Cause of Death
Coronary Artery Disease / diagnosis,  epidemiology,  mortality
Creatinine / blood
Embolism, Cholesterol / diagnosis,  epidemiology*,  mortality
Heart Failure / diagnosis,  epidemiology,  mortality
Hemorrhage / diagnosis,  epidemiology,  mortality
Kidney Failure, Chronic / diagnosis,  epidemiology*,  mortality
Kidney Function Tests
Middle Aged
Prospective Studies
Risk Factors
Statistics as Topic
Stroke / diagnosis,  epidemiology,  mortality
Reg. No./Substance:

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