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- Title
National Impact of Maintenance Dialysis or Renal Transplantation on Outcomes Following ST Elevation Myocardial Infarction.
- Authors
Sakhuja, Ankit; Wright, R. Scott; Schold, Jesse D.; McCarthy, James T.; Williams, Amy W.; Amer, Hatem; Albright, Robert C.
- Abstract
<bold>Background: </bold>Though cardiovascular disease is an important cause of mortality in patients with end-stage renal disease, epidemiology of ST-elevation myocardial infarction (STEMI) is less well described in this population.<bold>Methods: </bold>This study included STEMI hospitalizations in patients aged ≥20 using Nationwide Inpatient Sample Database from 2006 to 2010. Primary outcomes were incidence and trends of STEMI hospitalizations based on renal function status. We also looked at utilization of revascularization procedures, all-cause-hospital mortality and predictors of mortality.<bold>Results: </bold>Of the estimated 882,447 STEMI hospitalizations, 11,383 were on maintenance dialysis and 1,076 had renal transplants. The incidence of STEMI was over 7 times in patients on maintenance dialysis and 1.73 times in renal transplant recipients compared to the general population. This incidence has however declined in those on maintenance dialysis (p for trend <0.001) to a greater extent than the general population and patients with renal transplant. Utilization of revascularization procedures was lowest in patients on maintenance dialysis (51.6 vs. 73.3% in renal transplant recipients and 77.0% in general population; p < 0.001) and mortality was highest (21.6 vs. 10.9 vs. 6.8%; p < 0.001). Being on maintenance dialysis or having a renal transplant were both independent predictors of mortality in patients hospitalized with STEMI. There was a differential effect of cardiac catheterization on odds of mortality with lesser impact in patients on maintenance dialysis.<bold>Conclusions: </bold>STEMI hospitalizations are more common in patients on maintenance dialysis and with renal transplants. The utilization of revascularizations procedures remains low and mortality high in these patients.
- Subjects
UNITED States; TREATMENT of chronic kidney failure; CHRONIC kidney failure complications; HEMODIALYSIS; HOSPITAL care; KIDNEY transplantation; MYOCARDIAL revascularization; SURGICAL complications; DISEASE incidence; RETROSPECTIVE studies
- Publication
American Journal of Nephrology, 2016, Vol 44, Issue 5, p329
- ISSN
0250-8095
- Publication type
journal article
- DOI
10.1159/000450834