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.
chronic kidney disease, diabetes, myocardial infarction
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Copyright © 2015 Tisminetzky et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
DOI of Published Version
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
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.
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial 3.0 License
Cardiology Commons, Cardiovascular Diseases Commons, Clinical Epidemiology Commons, Epidemiology Commons, Female Urogenital Diseases and Pregnancy Complications Commons, Health Services Research Commons, Male Urogenital Diseases Commons, Nephrology Commons