Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease

Johnston, Nicola; Dargie, H. J.; Jardine, Alan G.

doi:10.1136/hrt.2007.136739

Cited by 24 publications

(22 citation statements)

References 22 publications

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“…Other authors have also shown a low rate of cardioprotective drug use in CKD patients. 17 This fact is associated with high early and late mortality, and inferior therapeutic response to pharmacological and non-pharmacological interventions alike. 1,2 CKD patients have both classic and uremia-related risk factors.…”

Section: Discussionmentioning

confidence: 99%

Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Lordsleem¹,

Gueiros²,

Gueiros³

et al. 2012

J. Bras. Nefrol.

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ResumoIntrodução: Pacientes com doença renal crônica (DRC) apresentam sinergismo entre fatores de risco tradicionais para aterosclerose e emergentes derivados do estado urêmico. Objetivo: Traçar o perfil epidemiológico de um grupo de pacientes com DRC submetido à avaliação cardiológica. Métodos: Pacientes sintomáticos -com isquemia em cintilografia miocárdica e/ou disfunção sistólica ao ecodopplercardiograma -com idade maior que 50 anos e diabetes mellitus (DM) como causa da DRC e aqueles com dois ou mais fatores de risco ateroscleróticos realizaram cineangiocoronariografia. Assintomáticos -não diabéticos e sem fatores de risco -foram investigados com ecodopplercardiograma e aqueles com único fator de risco, por meio de ecodopplercardiograma e cintilografia. Resultados: Foram estudados 46 pacientes, 58,7% homens, idade de 50-70 ± 11,7 anos, 91,3% dialíticos. Tempo de hemodiálise: 61,96 ± 55,1 meses. Hipertensão arterial foi causa da DRC em 56,5%. Dos 28 pacientes (60,9%) submetidos à cineangiocoronariografia, 53,6% apresentaram doença arterial coronariana (DAC). Os pacientes foram divididos em três grupos: com DAC (A), sem DAC (B) e não submetidos à cineangiocoronariografia (C). Diferença significativa ocorreu entre os Grupos B e C na frequên-cia de índice tibiobraquial (ITB) anormal (p = 0,026), com ausência de ITB anormal no Grupo C e na média de idade, superior no B (p = 0,045). No Grupo A, 53,3% dos pacientes estavam em avaliação pré-paratireoidectomia (PTX). Conclusão: Este estudo confirmou a alta frequência de alterações cardiovasculares, inclusive de DAC, nos pacientes portadores de DRC, principalmente naqueles em diálise. Palavras-chave: Doença das coronárias. Insuficiência renal crônica. Inflamação. Aterosclerose. AbstRActIntroduction: Patients with chronic kidney disease (CKD) experiment a synergistic effect of the traditional and the emerging uremia-related risk factors for atherosclerosis. Objective: Draw the epidemiologic profile of a group of CKD patients who underwent cardiac evaluation. Methods: Symptomatic patients, patients with ischemia on myocardial scintigraphy and/or systolic dysfunction on echocardiography, patients older than 50 years and diabetes mellitus (DM) as a cause of CKD, and those with two or more risk factors underwent coronary angiography. Asymptomatic, non-diabetic patients and patients with no risk factors were investigated with echocardiography. Those with a single risk factor were investigated with echocardiography and scintigraphy. Results: 46 patients (58.7% men) were enrolled. Their mean age was 50.7 ± 11.7 years. 91.3% were on dialysis, for 61.96 ± 55.1 months. Hypertension was the cause of CKD in 56.5%. Of the 28 patients (60.9%) who underwent angiography, 53.6% had coronary artery disease (CAD). The patients were divided into three groups: those with CAD (A), those without CAD (B) and those who didn't undergo coronary angiography (C). A significant difference occurred only between groups B and C, as regards an abnormal ABI (p = 0.026), with no ABI abnormality in group...

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Section: Discussionmentioning

confidence: 99%

Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Lordsleem¹,

Gueiros²,

Gueiros³

et al. 2012

J. Bras. Nefrol.

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“…Prema nalazu koronarografije bolesnici koji se leče hemodijalizom mogu se podeliti u dve grupe: sa visokim rizikom za razvoj akutnog koronarnog sindroma (koronarna arterijska bolest glavne leve koronarne arterije, trosudovna bolest -ateroskleroza sva tri kronarna arterijska krvna suda, umereni simptomi i smanjena funkcija leve komore, dvosudovna bolest sa zahvatanjem proksimalnog dela leve koronarne arterije) i sa niskim rizikom za razvoj akutnog koronarnog sindroma (jednosudovna bolest -zahvaćenost samo jednog koronarnog krvnog suda i dobra funkcija miokarda) (52)(53)(54). Kod bolesnika sa visokim rizikom CABG (coronary artery by pass grafting) smanjuje rizik od akutnog koronarnog sindroma, a kod bolesnika sa niskim rizikom primenjuje se lečenje medikamentima i perkutana transluminalna angioplastika (PTCA) ili ugradnja stenta -CAS (coronary artery stenting) (52)(53)(54). Implantabilni kardioverter defibrilator ugrađuje se kod bolesnika koji se leče ponavljanim hemodijalizama, kod kojih je ejekciona frakcija leve komore (EFLK) < 35% i koji su preživeli srčani zastoj izazvan komorskim poremećajima srčanog ritma (ventrikularna tahikardija / ventrikularna fibrilacija) (55 …”

Section: Tabela 2 Preporuke Za Faktore Kardiovaskularnog Rizika Kod unclassified

10.5937/mckg48-4123 = Diastolic heart failure in patients on hemodialysis: Etiopathogenesis, diagnostics and therapy

Nedeljković¹,

Miloradović²,

Radovanović³

et al. 2014

Medicinski casopis

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UVODBolesti srca su vodeći uzrok smrti bolesnika koji se leče redovnim hemodijalizama. Kod ovih bolesnika prisutni su brojni faktori rizika kao što su povišen arterijski krvni pritisak, poremećaj metabolizma lipida, oksidativni stres, mikroinflamacija, hiperhomocisteinemija, anemija, povećan protok krvi kroz vaskularni pristup za hemodijalizu, sekundarni hiperparatireoidizam, a koji su odgovorni za razvoj kardiovaskularnih komplikacija (1). Hipertrofija leve komore, ishemijska bolest srca i srčana slabost su najčešće kardiovaskularne komplikacije kod bolesnika na hemodijalizi (1, 2). PREGLED SAŽETAK

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“…According to coronarographic findings, HD patients are at either high risk (coronary disease of the main left ventricular artery; three-vessel coronary disease, mild symptoms and decreased left ventricular function; two-vessel disease involving the proximal left coronary artery) or low risk for acute coronary syndrome (single-vessel coronary disease -only one vessel involved and preserved myocardial function) (6,39,40). Coronary artery bypass grafting (CABG) decreases the risk of acute coronary syndrome in the high-risk group, whereas patients at low risk are usually treated with drugs, percutaneous transluminal angioplasty (PTCA) or coronary artery stenting (CAS) (6,39,40).…”

Section: Coronary Revascularisationmentioning

confidence: 99%

Sudden cardiac death in haemodialysis patients: Assessment of risk factors and prevention

Petrović¹,

Trbojević-Stanković²,

Stojanovic-Marjanovic³

et al. 2013

Ser J Exp Clin Res

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Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease

Cited by 24 publications

References 22 publications

Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

10.5937/mckg48-4123 = Diastolic heart failure in patients on hemodialysis: Etiopathogenesis, diagnostics and therapy

Sudden cardiac death in haemodialysis patients: Assessment of risk factors and prevention

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