Trends in Mortality Due to Myocardial Infarction, Stroke, and Pulmonary Embolism in Patients Receiving Dialysis.


Journal

JAMA network open
ISSN: 2574-3805
Titre abrégé: JAMA Netw Open
Pays: United States
ID NLM: 101729235

Informations de publication

Date de publication:
01 04 2022
Historique:
entrez: 18 4 2022
pubmed: 19 4 2022
medline: 21 4 2022
Statut: epublish

Résumé

During the past decades, improvements in the prevention and management of myocardial infarction, stroke, and pulmonary embolism have led to a decline in cardiovascular mortality in the general population. However, it is unknown whether patients receiving dialysis have also benefited from these improvements. To assess the mortality rates for myocardial infarction, stroke, and pulmonary embolism in a large cohort of European patients receiving dialysis compared with the general population. In this cohort study, adult patients who started dialysis between 1998 and 2015 from 11 European countries providing data to the European Renal Association Registry were and followed up for 3 years. Data were analyzed from September 2020 to February 2022. Start of dialysis. The age- and sex-standardized mortality rate ratios (SMRs) with 95% CIs were calculated by dividing the mortality rates in patients receiving dialysis by the mortality rates in the general population for 3 equal periods (1998-2003, 2004-2009, and 2010-2015). In total, 220 467 patients receiving dialysis were included in the study. Their median (IQR) age was 68.2 (56.5-76.4) years, and 82 068 patients (37.2%) were female. During follow-up, 83 912 patients died, of whom 7662 (9.1%) died because of myocardial infarction, 5030 (6.0%) died because of stroke, and 435 (0.5%) died because of pulmonary embolism. Between the periods 1998 to 2003 and 2010 to 2015, the SMR of myocardial infarction decreased from 8.1 (95% CI, 7.8-8.3) to 6.8 (95% CI, 6.5-7.1), the SMR of stroke decreased from 7.3 (95% CI, 7.0-7.6) to 5.8 (95% CI, 5.5-6.2), and the SMR of pulmonary embolism decreased from 8.7 (95% CI, 7.6-10.1) to 5.5 (95% CI, 4.5-6.6). In this cohort study of patients receiving dialysis, mortality rates for myocardial infarction, stroke, and pulmonary embolism decreased more over time than in the general population.

Identifiants

pubmed: 35435972
pii: 2791202
doi: 10.1001/jamanetworkopen.2022.7624
pmc: PMC9016490
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e227624

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Auteurs

Gurbey Ocak (G)

Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, the Netherlands.

Rianne Boenink (R)

European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands.

Marlies Noordzij (M)

European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands.

Willem Jan W Bos (WJW)

Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, the Netherlands.
Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands.

Bjorn E Vikse (BE)

Department of Clinical Medicine, University of Bergen, Bergen, Norway.
Department of Medicine, Haugesund Hospital, Haugesund, Norway.

Aleix Cases (A)

Nephrology Department, Hospital Clínic, Universitat de Barcelona, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain.
Registre de Malalts Renals de Catalunya, Barcelona, Spain.

Julia Kerschbaum (J)

Department of Internal Medicine IV - Nephrology and Hypertension, Austrian Dialysis and Transplant Registry, Medical University Innsbruck, Innsbruck, Austria.

Jaakko Helve (J)

Finnish Registry for Kidney Diseases, Helsinki, Finland.
Abdominal Center Nephrology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.

Maurizio Nordio (M)

Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy.
Nephrology Dialysis and Renal Transplantation Unit, Treviso, Italy.

Mustafa Arici (M)

Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.

Lucile Mercadal (L)

Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital de La Pitié Salpêtrière Hospital, Paris, France.

Christoph Wanner (C)

Division of Nephrology, Department of Medicine, University Hospital of Würzburg, Würzburg, Germany.

Runolfur Palsson (R)

Division of Nephrology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.
Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.

Kristine Hommel (K)

Department of Medicine, Holbaek Hospital, Holbaek, Denmark.

Johan De Meester (J)

Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium.

Myrto Kostopoulou (M)

Department of Nephrology, General Hospital, Athens, Greece.

Rafael Santamaria (R)

Andalusian Autonomous Transplant Coordination Information System, Seville, Spain.
Nephrology ServiceReina Sofia University Hospital, Cordoba, Spain.

Emilio Rodrigo (E)

Nephrology Service, University Hospital Marqués de Valdecilla/IDIVAL, University of Cantabria, Santander, Spain.

Helena Rydell (H)

Division of Renal Medicine, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Swedish Renal Registry, Department of Internal Medicine, Ryhov Regional Hospital, Jönköping, Sweden.

Samira Bell (S)

Scottish Renal Registry, Meridian Court, Glasgow, United Kingdom.
Division of Population health And Genomics, University of Dundee, Dundee, United Kingdom.

Ziad A Massy (ZA)

Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France.
Institut National de la Santé et de la Recherche Médicale, Research Centre in Epidemiology and Population Health, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France.

Kitty J Jager (KJ)

European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands.

Anneke Kramer (A)

European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands.

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