Pharmacotherapy in Chronic Kidney Disease Patients Presenting With Acute Coronary Syndrome

Washam, Jeffrey B.; Herzog, Charles A.; Beitelshees, Amber L.; Cohen, Mauricio G.; Henry, Timothy D.; Kapur, Navin K.; Mega, Jessica L.; Menon, Venu; Page, Robert L.; Newby, L. Kristin

doi:10.1161/cir.0000000000000183

Cited by 68 publications

(55 citation statements)

References 135 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12 Cardiac troponin levels are more likely to be chronically elevated in people with kidney failure than in the general population, 13 emphasizing the importance of searching for a temporally appropriate rise and fall of these biomarkers when considering the possibility of acute coronary syndrome. 14 Existing epidemiological data related to CAD are limited by the considerations above and by the relatively poor predictive performance of exercise stress testing, radionuclide perfusion imaging, and stress echocardiography in people with advanced CKD. [15][16][17] At least in the relatively healthier subset of patients with advanced CKD who are potential candidates for kidney transplantation, stress echocardiography appears to be associated with higher sensitivity and specificity for critical coronary disease than radionuclide perfusion imaging.…”

mentioning

confidence: 99%

Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease

2016

View full text Add to dashboard Cite

Abstract-Patients with chronic kidney disease and end-stage renal disease are at 5-to 10-fold higher risk for developing cardiovascular disease (CVD) than age-matched controls. Clinically, CVD in this population manifests as coronary artery disease, arrhythmias, stroke, or congestive heart failure. Beyond the traditional risk factors (eg, diabetes mellitus and hypertension), uremia-specific factors that arise from accumulating toxins also contribute to the pathogenesis of CVD.In this review, we summarize the literature on the epidemiology of both traditional and uremia-related CVD and focus on postulated mechanisms of the latter. P. Jousset, MD, 1 describing common causes of death among patients with Bright disease C hronic kidney disease (CKD) is an increasingly urgent public health concern that is projected to grow worldwide at a rate of 8% annually, with the fastest growth expected in developing nations.2,3 It has long been known that patients with kidney failure are predisposed to cardiovascular disease (CVD) that manifests clinically in various forms, including coronary artery disease, atrial or ventricular arrhythmias, myocardial infarction, stroke, or congestive heart failure. Over the last 30 years, it has become clear that the risk of CVD increases early in the course of progressive kidney disease and that the epidemiology, pathophysiology, prevention, and treatment of CVD and CKD are closely related and interdependent. 4 In this review, we initially describe the epidemiology of CVD among people with CKD, noting the limitations of available research. We then discuss common risk factors for CVD (traditional and nontraditional) and key shared aspects of its pathophysiology with CKD. Next we describe emerging diagnostic tools and novel therapies that may help to delay or prevent end-stage renal disease (ESRD) and to curtail the escalating burden of cardiorenal disease. In the final section, we discuss the health services and health policy challenges that CKD and its inextricably linked CVD morbidities pose worldwide, particularly for low-and middle-income countries (LMICs). Phenotypes and Epidemiology of CVD in Patients With CKDPatients with CKD and some forms of CVD share a number of risk factors and underlying pathophysiological mechanisms that, by virtue of their similarities, offer opportunities to improve their management. The epidemiology of 4 of the commonest clinical phenotypes of CVD associated with CKD is discussed below. Coronary Artery DiseaseCoronary artery disease (CAD) is a leading cause of death among people with advanced CKD. Clinical syndromes compatible with CAD (including angina and myocardial infarction) are exceedingly common in patients with nondialysis-dependent CKD, and the incidence of myocardial

show abstract

mentioning

confidence: 99%

Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease

2016

View full text Add to dashboard Cite

show abstract

“…One clinical trial, which was conducted in Japan and focused on diabetes, failed to find significant differences, although the study was underpowered 31. The American Heart Association, in recent scientific statements, emphasized stricter criteria for aspirin use in high‐risk individuals balancing benefits and harm 8, 9, 10, 11. These reports could have changed aspirin use patterns since 2009.…”

Section: Discussionmentioning

confidence: 99%

“…After review of data from multiple prospective randomized clinical trials,4, 5, 6 the United States Preventive Services Task Force (USPSTF) in 2009 published a strong 1A recommendation in favor of use of low‐dose aspirin for primary prevention in men aged 45 to 79 years and women aged 55 to 79 years in whom benefit would be anticipated to exceed risk 7. The recommendation in favor of aspirin use was also included in an American Heart Association prevention guidelines,8, 9, 10, 11 the recent Healthy People 2020 plan,12 and the “Million Hearts Initiative” of the Centers for Medicare and Medicaid Services and Centers for Disease Control and Prevention 13…”

Section: Introductionmentioning

confidence: 99%

Population Trends in Aspirin Use for Cardiovascular Disease Prevention 1980–2009: The Minnesota Heart Survey

Luepker

Steffen

Duval

et al. 2015

JAHA

View full text Add to dashboard Cite

BackgroundDaily low‐dose aspirin is recommended for primary prevention of myocardial infarction and stroke in higher‐risk patients. Population trends in aspirin use for cardiovascular disease (CVD) prevention in an urban population (Minneapolis/St. Paul, 2010 population 2.85 million) from 1980 to 2009 were evaluated.Methods and ResultsSurveys of randomly selected adults aged 25 to 74 years were collected at 5‐year intervals. Self‐reports of regular aspirin use for CVD prevention and history of CVD were obtained. Six cross‐sectional surveys included 12 281 men and 14 258 women. Age‐adjusted aspirin use for primary prevention increased during this period from 1% to 21% among men and 1% to 12% among women. Aspirin use was highest in those aged 65 to 74 years. For secondary prevention, age‐adjusted aspirin use increased from 19% to 74% among men and 11% to 64% among women. While data are based on self‐report, a substudy using a biochemical indicator of aspirin use (serum thromboxane B2) supports the validity of self‐report.ConclusionsAspirin for CVD prevention is commonly used by a large and growing portion of the general population. It is not known if this is based on professional advice or self‐prescribed use. It is also likely that many who would benefit do not use aspirin and others use aspirin inappropriately.

show abstract

“…В 2015 г. Американская Ассоциация Сердца выпустила документ, регулирующих медика-ментозную терапию ОКС у пациентов с хро-нической болезнью почек [20]. Согласно этому документу, фондапаринукс противопоказан у пациентов с клиренсом креатинина менее 30 мл/мин, но является препаратом выбора на-равне с бивалирудином у пациентов с умерен-ным снижением почечной функции (3 стадия хронической болезни почек, клиренс креати-нина 30-60 мл/мин), поскольку в наибольшей степени предотвращает кровотечения именно у этой категории пациентов.…”

Section: практические аспекты применения фондапаринукса при оксunclassified

Fondaparinux in the Treatment of Acute Coronary Syndrome

Шахматова¹

2017

Aterotromboz

View full text Add to dashboard Cite

Pharmacotherapy in Chronic Kidney Disease Patients Presenting With Acute Coronary Syndrome

Cited by 68 publications

References 135 publications

Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease

Epidemiology and Mechanisms of Uremia-Related Cardiovascular Disease

Population Trends in Aspirin Use for Cardiovascular Disease Prevention 1980–2009: The Minnesota Heart Survey

Fondaparinux in the Treatment of Acute Coronary Syndrome

Contact Info

Product

Resources

About