ArticleClinical cardiology2012
Quality of care and outcomes among patients with acute myocardial infarction by level of kidney function at admission: report from the get with the guidelines coronary artery disease program.
Article in Clinical cardiology, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Clinical features, use of evidence-based therapies, and cardiovascular outcomes among patients with chronic kidney disease following non-ST-elevation acute coronary syndrome.Clinical cardiology · 2014Trial
- Addition of N-acetyl cysteine to carvedilol decreases the incidence of acute renal injury after cardiac surgery.Clinical cardiology · 2014Trial
- Acute coronary events in kidney patients: the dialysis dilemma.The British journal of cardiology · 2025Article
- Association between kidney function, frailty and receipt of invasive management after acute coronary syndrome.Open heart · 2024Article
- Impact of Chronic Kidney Disease on the Processes of Care and Long-Term Mortality of Non-ST-Segment-Elevation Myocardial Infarction: A Nationwide Cohort Study and Long-Term Follow-Up.Journal of the American Heart Association · 2024Article
- Prognostic Impact of Percutaneous Coronary Intervention in Chronic Dialysis Patients with Acute Myocardial Infarction:Reviews in cardiovascular medicine · 2023Article
- Temporal Trends in Utilization of Cardiac Therapies and Outcomes for Myocardial Infarction by Degree of Chronic Kidney Disease: A Report From the NCDR Chest Pain-MI Registry.Journal of the American Heart Association · 2018Article
- Chronic Kidney Disease and Health Status Outcomes Following Acute Myocardial Infarction.Journal of the American Heart Association · 2016Observational
- Chronic Kidney Disease and Acute Myocardial Infarction: The Story After 1 Year.Journal of the American Heart Association · 2016Article
- Estimated Glomerular Filtration Rate and Mortality among Patients with Coronary Heart Disease.PloS one · 2016Article
- Trends in Mortality Following Acute Myocardial Infarction Among Dialysis Patients in the United States Over 15 Years.Journal of the American Heart Association · 2015Observational
- Association of chronic renal insufficiency with in-hospital outcomes after percutaneous coronary intervention.Journal of the American Heart Association · 2015Article
- Patterns of care quality and prognosis among hospitalized ischemic stroke patients with chronic kidney disease.Journal of the American Heart Association · 2014Article
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Authors and funding
12 authors.
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Abstract
backgroundMany patients admitted for acute myocardial infarction (AMI) have chronic renal insufficiency. We studied the impact of chronic renal insufficiency on mortality and quality of inpatient care for AMI from the American Heart Association's Get With The Guidelines-Coronary Artery Disease Program. HYPOTHESIS: We hypothesized that mortality and quality of inpatient care would not vary with renal function.
methodsWe examined in-hospital AMI performance measures by renal function based on glomerular filtration rate (GFR). Severity of renal insufficiency was categorized as normal (GFR ≥ 90 mL/min/1.73 m(2)), mild (GFR 60-90 mL/min/1.73 m(2)), moderate (GFR 30-60 mL/min/1.73 m(2)), severe (GFR 15-30 mL/min/1.73 m(2)), and kidney failure (GFR ≤ 15 mL/min/1.73 m(2) or dialysis). A total of 21721 patients from 291 sites were studied, with most data collected in 2008 to 2009. Multivariable regression analysis after adjusting for patient characteristics was performed and generalized estimating equations were used to account for within-hospital clustering. In-hospital mortality and quality of inpatient care were assessed.
resultsRenal insufficiency was present in 82.0 percent of AMI patients. The adjusted odds ratio vs normal renal function for mortality increased with worsening renal function: 1.45 for mild renal insufficiency (95% confidence interval [CI]: 1.03-2.05, P = 0.03); 3.36 for moderate renal insufficiency (95% CI: 2.31-4.89, P < 0.0001); 5.43 for severe renal insufficiency (95% CI: 3.70-7.95, P < 0.0001); and 6.35 for kidney failure (95% CI: 4.48-9.01, P < 0.0001). Patients with renal insufficiency received less inpatient and discharge guideline-recommended therapy for AMI.
conclusionsAmong AMI patients, mortality and guideline-recommended inpatient therapy correlated inversely with renal function. Adjusted mortality was equally poor among patients with severe renal dysfunction and on dialysis.
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