Impact of chronic kidney disease on mortality and cardiovascular outcomes after acute coronary syndrome: A nationwide data linkage study (ANZACS-QI 44).
Acute Coronary Syndrome
/ diagnosis
Cardiovascular Diseases
/ mortality
Coronary Angiography
/ methods
Correlation of Data
Female
Heart Disease Risk Factors
Hospitalization
/ statistics & numerical data
Humans
Kidney Function Tests
/ statistics & numerical data
Male
Middle Aged
Mortality
New Zealand
/ epidemiology
Patient Care Management
/ methods
Quality Improvement
Registries
/ statistics & numerical data
Renal Insufficiency, Chronic
/ diagnosis
Severity of Illness Index
Social Determinants of Health
acute coronary syndrome
cardiovascular
chronic kidney disease
mortality
Journal
Nephrology (Carlton, Vic.)
ISSN: 1440-1797
Titre abrégé: Nephrology (Carlton)
Pays: Australia
ID NLM: 9615568
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
23
10
2019
revised:
09
01
2020
accepted:
11
01
2020
pubmed:
28
2
2020
medline:
30
3
2021
entrez:
28
2
2020
Statut:
ppublish
Résumé
Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease (CVD). We examined the characteristics, management and outcomes of patients with CKD in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) national registry. The cohort comprised New Zealand (NZ) patients with an acute coronary syndrome undergoing coronary angiography between January 2013 and December 2016. Patients were categorized according to their stage of CKD. Outcomes included all-cause and cause-specific mortality and hospitalization with myocardial infarction (MI), stroke and major bleeding. Of the 20 604 patients, 20.3% had normal renal function, with 53.3%, 23.3%, 1.7% and 1.4% having CKD stages 2, 3, 4 and 5 CKD, respectively. Patients with severe CKD were more likely to be Māori or Pacific and live in an area with greater socioeconomic deprivation. Death, recurrent MI or stroke, and major bleeding all increased incrementally with each worsening stage of CKD severity. Compared with those with normal renal function, patients with stage 5 CKD had a much higher all-cause (hazard ratio [HR] 16.41, 95% CI 13.06-20.61), cardiovascular (HR 16.38, 95% CI 12.17-22.04) and non-cardiovascular mortality (HR 13.66 9, 95% CI.56-19.51). In addition, patients with stage 5 CKD were at a higher risk of recurrent MI or stroke (HR 4.73, 95% CI 3.86-5.80) and bleeding (HR 5.84, 95% CI 4.39-7.76). CKD was associated with increased mortality and a high incidence of morbidity in patients undergoing coronary angiography in New Zealand. Initiatives to understand and improve outcomes in this group of patients are urgently needed.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
535-543Subventions
Organisme : A + Trust
ID : A+ 7748
Organisme : Health Research Council of New Zealand
Organisme : Middlemore Cardiac Trust
Informations de copyright
© 2020 Asian Pacific Society of Nephrology.
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