Impact of dialysis dependence on prognosis in patients with myocardial infarction: An 11-year population-based study. Issue 6 (February 2018)

• Record Type: Journal Article
• Authors: Fu, Chung-Ming; Chang, Chih-Hsiang; Lee, Cheng-Chia; Fan, Pei-Chun; Chen, Shao-Wei; Lee, Chien-Te; Wu, Chien-Hsing; Li, Lung-Chih; Chen, Tien-Hsing
• Other Names: Xu. Jinxian section editor.
• Is Part Of: Medicine. Volume 97:Issue 6(2018)
• Publication Date: 2018-02
• Subjects: acute myocardial infarction -- chronic kidney disease -- coronary artery disease -- dialysis -- prognosis; Medicine -- Periodicals; Medicine -- Periodicals; Médecine -- Périodiques; Geneeskunde; Medicine; Periodicals; Periodicals; 610.5
• DOI: 10.1097/MD.0000000000009833
• Languages: English
• ISSNs: 0025-7974

Abstract

Abstract : Abstract: In this study we aimed to directly compare the short and long-term prognosis of nondialysis patients with chronic kidney disease (CKD), dialysis patients, and patients with preserved renal function after acute myocardial infarction (AMI). AMI in patients with CKD is a catastrophic event associated with high medical expenditures and dismal survival. However, there is little research comparing post-AMI outcomes between patients with CKD who were and were not receiving dialysis. The retrospective cohort study included patients with AMI (n = 158, 125) in the Taiwan's National Health Insurance Research Database who were treated March 1998 and December 2009. Patients were classified into a nondialysis CKD group (n = 6300), dialysis group (n = 5140), and a control group (n = 146, 685). The clinical characteristics, in-hospital events, and long-term outcomes of these 3 groups were compared separately using a multivariable Cox proportional hazard model. The risks of in-hospital death and 2-year all-cause mortality were the highest in the dialysis group, followed by the nondialysis CKD group, and were the lowest in the control group. The 1-year risk of myocardial infarction did not differ among the 3 study groups, but the 2-year risk of myocardial infarction was higher in the dialysis group than in the control group (hazard ratio, 1.13; 95% confidence interval, 1.03–1.24; P = .010). Patients with CKD experienced adverse short- and long-term outcomes after acute myocardial infarction. Patients with CKD, especially those who are dialysis dependent, may require more intensive management to improve their post-AMI clinical outcomes. Abstract : Supplemental Digital Content is available in the text