National Impact of Maintenance Dialysis or Renal Transplantation on Outcomes Following ST Elevation Myocardial Infarction

Ankit Sakhuja, R. Scott Wright, Jesse D. Schold, James T. McCarthy, Amy W. Williams, Hatem Amer, Robert C. Albright

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Though cardiovascular disease is an important cause of mortality in patients with end-stage renal disease, epidemiology of ST-elevation myocardial infarction (STEMI) is less well described in this population. Methods: This study included STEMI hospitalizations in patients aged ≥20 using Nationwide Inpatient Sample Database from 2006 to 2010. Primary outcomes were incidence and trends of STEMI hospitalizations based on renal function status. We also looked at utilization of revascularization procedures, all-cause-hospital mortality and predictors of mortality. Results: Of the estimated 882,447 STEMI hospitalizations, 11,383 were on maintenance dialysis and 1,076 had renal transplants. The incidence of STEMI was over 7 times in patients on maintenance dialysis and 1.73 times in renal transplant recipients compared to the general population. This incidence has however declined in those on maintenance dialysis (p for trend <0.001) to a greater extent than the general population and patients with renal transplant. Utilization of revascularization procedures was lowest in patients on maintenance dialysis (51.6 vs. 73.3% in renal transplant recipients and 77.0% in general population; p < 0.001) and mortality was highest (21.6 vs. 10.9 vs. 6.8%; p < 0.001). Being on maintenance dialysis or having a renal transplant were both independent predictors of mortality in patients hospitalized with STEMI. There was a differential effect of cardiac catheterization on odds of mortality with lesser impact in patients on maintenance dialysis. Conclusions: STEMI hospitalizations are more common in patients on maintenance dialysis and with renal transplants. The utilization of revascularizations procedures remains low and mortality high in these patients.

Original languageEnglish (US)
Pages (from-to)329-338
Number of pages10
JournalAmerican Journal of Nephrology
DOIs
StateAccepted/In press - Oct 6 2016

Fingerprint

Kidney Transplantation
Dialysis
Maintenance
Kidney
Mortality
Hospitalization
Transplants
Population
Incidence
ST Elevation Myocardial Infarction
Cardiac Catheterization
Hospital Mortality
Chronic Kidney Failure
Renal Dialysis
Inpatients
Epidemiology
Cardiovascular Diseases
Databases

Keywords

  • End-stage renal disease
  • Mortality
  • Renal transplant
  • ST-elevation myocardial infarction 

ASJC Scopus subject areas

  • Nephrology

Cite this

National Impact of Maintenance Dialysis or Renal Transplantation on Outcomes Following ST Elevation Myocardial Infarction. / Sakhuja, Ankit; Wright, R. Scott; Schold, Jesse D.; McCarthy, James T.; Williams, Amy W.; Amer, Hatem; Albright, Robert C.

In: American Journal of Nephrology, 06.10.2016, p. 329-338.

Research output: Contribution to journalArticle

Sakhuja, Ankit ; Wright, R. Scott ; Schold, Jesse D. ; McCarthy, James T. ; Williams, Amy W. ; Amer, Hatem ; Albright, Robert C. / National Impact of Maintenance Dialysis or Renal Transplantation on Outcomes Following ST Elevation Myocardial Infarction. In: American Journal of Nephrology. 2016 ; pp. 329-338.
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