Differential Symptoms of Acute Myocardial Infarction in Patients With Kidney Disease: A Community-Wide Perspective

Sosnov, Jonathan A.; Lessard, Darleen M.; Goldberg, Robert J.; Yarzebski, Jorge L.; Gore, Joel M.

doi:10.1053/j.ajkd.2005.11.017

Cited by 116 publications

(89 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Further diagnostic confusion may have resulted from the greater prevalence of hypertension and likely attendant hypertensive heart disease and uninterpretable ST depression in the dialysis cohort. Our finding of a lower prevalence of chest pain in dialysis patients with AMI is concordant with the study by Sosnov et al, 9 which reported that patients with chronic kidney disease (estimated glomerular filtration rate Ͻ60 mL · min Ϫ1 · 1.73 m Ϫ2 ) in the Worcester Heart Attack Study were 43% less likely to report chest pain than patients Values are given as n (%) unless otherwise indicated. *Probability values are adjusted for multiple comparisons with the Bonferroni method.…”

Section: Discussionsupporting

confidence: 91%

Clinical Characteristics of Dialysis Patients With Acute Myocardial Infarction in the United States

et al. 2007

View full text Add to dashboard Cite

Background-Acute myocardial infarction (AMI) is catastrophic for dialysis patients. This study set out to determine the clinical characteristics of dialysis patients hospitalized for AMI in the United States. Cardiac arrest was twice as frequent for dialysis patients (11.0% versus 5.0%), and in-hospital death was nearly so (21.3% versus 11.7%). In a logistic regression model, the odds ratio for in-hospital death for dialysis versus nondialysis patients was 1.498 (95% CI, 1.340 to 1.674). Conclusions-Dialysis patients hospitalized for AMI differ strikingly from nondialysis patients, which possibly explains their poor outcomes. Intensive efforts for early, accurate recognition of AMI in dialysis patients are warranted.

show abstract

Section: Discussionsupporting

confidence: 91%

Clinical Characteristics of Dialysis Patients With Acute Myocardial Infarction in the United States

et al. 2007

View full text Add to dashboard Cite

show abstract

“…1,[11][12][13][14][15] First, the prevalence of chest pain among patients with ACS is inversely related to stage of CKD. As shown in Figure 3, there is a graded reduction in the frequency of chest pain as eGFR falls.…”

Section: Clinical Presentation Of Acs Among Ckd Patientsmentioning

confidence: 99%

Pharmacotherapy in Chronic Kidney Disease Patients Presenting With Acute Coronary Syndrome

Washam¹,

Herzog²,

Beitelshees³

et al. 2015

Circulation

View full text Add to dashboard Cite

“…More than 15 years have elapsed since the initial description of the dismal survival rates in this population based on data from the US Renal Data System (USRDS)1; the reported 1‐ and 2‐year mortality rates were 55% and 71%, respectively, for the 1977–1984 cohort and 62% and 74%, respectively, for the 1990–1995 cohort. Several factors have been postulated to explain worse outcomes following AMI among dialysis patients relative to the general population, including challenges in establishing a timely diagnosis of AMI due to atypical presentations and clinical characteristics,5, 6 lower use and effectiveness of “conventional” evidence‐based therapies,3, 4, 7, 8 and concern regarding therapeutic nihilism by the medical community toward these patients.…”

Section: Introductionmentioning

confidence: 99%

Trends in Mortality Following Acute Myocardial Infarction Among Dialysis Patients in the United States Over 15 Years

Shroff

Herzog

2015

JAHA

View full text Add to dashboard Cite

BackgroundWe sought to determine 15‐year trends in mortality rates among dialysis patients with acute myocardial infarction (AMI) in the contemporary era.Methods and ResultsUsing the US Renal Data System database, we assembled 4 study cohorts of period‐prevalent dialysis patients in 1993, 1998, 2003, and 2008 who were hospitalized for an index AMI in that calendar year. ST‐segment elevation myocardial infarction (STEMI) and non‐STEMI were identified, and in‐hospital mortality was calculated. Cumulative probability of death during 2‐year follow‐up after AMI admission was estimated by the Kaplan–Meier method and adjusted for patient characteristics. A total of 42 933 dialysis patients with AMI were included. Between 1993 (n=4494) and 2008 (n=16 361), proportional increases occurred in patient groups aged ≥75 years (23% and 31%, respectively; P<0.001), of black race (25% and 31%, respectively; P<0.001), with end‐stage renal disease due to diabetes (42% and 55%, respectively; P<0.001), and with non‐STEMI (42.2% and 80.7%, respectively; P<0.001). For all patients with AMI, in‐hospital mortality rates decreased (31.9% in 1993, 18.8% in 2008; P<0.001), as did unadjusted 2‐year cumulative probability of death after AMI admission (76.5% in 1993, 71.5% in 2008; P<0.001). Between 1993 and 2008, among STEMI patients, in‐hospital mortality (38.2% and 25.9%, P<0.001) and unadjusted 2‐year cumulative probability of mortality (77.3% and 71.2%, P<0.001) decreased, but decreases did not occur among NSTEMI patients (14.2% and 14.9%, P=0.47, and 70.9% and 70.1%, P=0.52 respectively).ConclusionsIn‐hospital mortality and 2‐year cumulative probability of death following AMI among dialysis patients decreased between 1993 and 2008 but only among STEMI patients, coincident with increased in‐hospital percutaneous coronary intervention rates. Period‐prevalent cases of non‐STEMI markedly increased without interval change in survival.

show abstract

Differential Symptoms of Acute Myocardial Infarction in Patients With Kidney Disease: A Community-Wide Perspective

Cited by 116 publications

References 15 publications

Clinical Characteristics of Dialysis Patients With Acute Myocardial Infarction in the United States

Clinical Characteristics of Dialysis Patients With Acute Myocardial Infarction in the United States

Pharmacotherapy in Chronic Kidney Disease Patients Presenting With Acute Coronary Syndrome

Trends in Mortality Following Acute Myocardial Infarction Among Dialysis Patients in the United States Over 15 Years

Contact Info

Product

Resources

About