Michael G. Shlipak, MD, MPH; Paul A. Heidenreich, MD, MS; Haruko Noguchi, PhD; Glenn M. Chertow, MD, MPH; Warren S. Browner, MD, MPH; Mark B. McClellan, MD, PhD
Shlipak MG, Heidenreich PA, Noguchi H, Chertow GM, Browner WS, McClellan MB. Association of Renal Insufficiency with Treatment and Outcomes after Myocardial Infarction in Elderly Patients. Ann Intern Med. 2002;137:555-562. doi: 10.7326/0003-4819-137-7-200210010-00006
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Published: Ann Intern Med. 2002;137(7):555-562.
Renal insufficiency increases the risk for cardiovascular disease, but whether it affects survival after myocardial infarction is unknown.
This large cohort study of Medicare beneficiaries hospitalized between April 1994 and July 1995 revealed the following: 1-year post–myocardial infarction mortality for no, mild, and moderate renal insufficiency was 24%, 46%, and 66%, respectively. Moderate renal insufficiency was more common in black and male patients and in patients with diabetes or previous stroke. Patients with moderate renal insufficiency received aspirin, β-blockers, thrombolytic therapy, angiography, and angioplasty less often than patients with mild or no renal insufficiency.
Patients with moderate renal insufficiency have increased mortality after myocardial infarction. They also get fewer effective treatments for myocardial infarction, which may explain the higher death rate.
< 0.001 by using the log-rank test for differences .
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Acute Coronary Syndromes, Cardiology, Coronary Heart Disease, Emergency Medicine, Nephrology.
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