Journal
EUROPEAN HEART JOURNAL
Volume 34, Issue 37, Pages 2916-+Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/eht220
Keywords
Chronic kidney disease; Renal replacement therapy; Myocardial infarction; Angiography; Coronary revascularization; Pharmacological treatment
Categories
Funding
- Danish Society of Nephrology
- Danish Kidney Association
- Helen and Ejnar Bjoernow Foundation
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The aim of this Danish nationwide study was to evaluate the treatment of myocardial infarction (MI) in patients with non-end-stage chronic kidney disease (CKD) and in patients requiring renal replacement therapy (RRT). Upgraded guidelines for the management of MI were implemented around 2004; hence, the treatment of MI in the time periods before and after 2004 was compared in order to evaluate the impact for patients with CKD. By linking nationwide registries by the personal registration number, we identified patients admitted to Danish hospitals with first time MI in the period 200009 (79 585 with no renal disease, 3144 with non-end-stage CKD, and 725 requiring RRT). Cox proportional hazards model was used to estimate the chance of invasive treatment within 60 days after MI and the chance of filling prescriptions on recommended post-MI drugs within 90 days before and after 2004. Significantly less use of relevant MI treatment in patients with non-end-stage CKD and patients requiring RRT compared with patients with no renal disease were seen; however, the absolute frequencies of invasive procedures and filled prescriptions on post-MI drugs increased after 2004 in all patients. After 2004, invasive and pharmacological treatment of first-time MI improved in patients with non-end-stage CKD and patients requiring RRT; however, all CKD patients were less treated with standard MI care compared with patients with no renal disease.
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