Department of Quantitative Health Sciences; Department of Medicine, Division of Cardiovascular Medicine; Department of Psychiatry
Cardiology | Cardiovascular Diseases | Clinical Epidemiology | Epidemiology | Female Urogenital Diseases and Pregnancy Complications | Health Services Research | Male Urogenital Diseases | Nephrology
BACKGROUND: Despite the increasing magnitude and impact, there are limited data available on the clinical management and in-hospital outcomes of patients who have diabetes mellitus (DM) and chronic kidney disease (CKD) at the time of hospitalization for acute myocardial infarction (AMI). The objectives of our population-based observational study in residents of central Massachusetts were to describe decade-long trends (1999-2009) in the characteristics, in-hospital management, and hospital outcomes of AMI patients with and without these comorbidities.
METHODS: We reviewed the medical records of 6,018 persons who were hospitalized for AMI on a biennial basis between 1999 and 2009 at all eleven medical centers in central Massachusetts. Our sample consisted of the following four groups: DM with CKD (n=587), CKD without DM (n=524), DM without CKD (n=1,442), and non-DM/non-CKD (n=3,465).
RESULTS: Diabetic patients with CKD were more likely to have a higher prevalence of previously diagnosed comorbidities, to have developed heart failure acutely, and to have a longer hospital stay compared with non-DM/non-CKD patients. Between 1999 and 2009, there were marked increases in the prescribing of beta-blockers, statins, and aspirin for patients with CKD and DM as compared to those without these comorbidities. In-hospital death rates remained unchanged in patients with DM and CKD, while they declined markedly in patients with CKD without DM (20.2% dying in 1999; 11.3% dying in 2009).
CONCLUSION: Despite increases in the prescribing of effective cardiac medications, AMI patients with DM and CKD continue to experience high in-hospital death rates.
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Citation: Int J Nephrol Renovasc Dis. 2015 May 5;8:41-51. doi: 10.2147/IJNRD.S78749. eCollection 2015. Link to article on publisher's site
DOI of Published Version
chronic kidney disease, diabetes, myocardial infarction
International journal of nephrology and renovascular disease
Tisminetzky, Mayra; McManus, David D.; Dor, Alon; Miozzo, Ruben; Yarzebski, Jorge L.; Gore, Joel M.; and Goldberg, Robert J., "Decade-long trends (1999-2009) in the characteristics, management, and hospital outcomes of patients hospitalized with acute myocardial infarction with prior diabetes and chronic kidney disease" (2015). Open Access Articles. 2733.
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