Background Cardiovascular disease is common in patients on long-termdialysis, and it accounts for 44 percent of overall mortalityin this group. We undertook a study to assess long-term survivalafter acute myocardial infarction among patients in the UnitedStates who were receiving long-term dialysis.
Methods Patients on dialysis who were hospitalized during theperiod from 1977 to 1995 for a first myocardial infarction afterthe initiation of renal-replacement therapy were retrospectivelyidentified from the U.S. Renal Data System data base. Overallmortality and mortality from cardiac causes (including all in-hospitaldeaths) were estimated by the life-table method. The effectof independent predictors on survival was examined in a Coxregression model with adjustment for existing illnesses.
Results The overall mortality (±SE) after acute myocardialinfarction among 34,189 patients on long-term dialysis was 59.3±0.3percent at one year, 73.0±0.3 percent at two years, and89.9±0.2 percent at five years. The mortality from cardiaccauses was 40.8±0.3 percent at one year, 51.8±0.3percent at two years, and 70.2±0.4 percent at five years.Patients who were older or had diabetes had higher mortalitythan patients without these characteristics. Adverse outcomesoccurred even in patients who had acute myocardial infarctionin 1990 through 1995. Also, the mortality rate after myocardialinfarction was considerably higher for patients on long-termdialysis than for renal-transplant recipients.
Conclusions Patients on dialysis who have acute myocardial infarctionhave high mortality from cardiac causes and poor long-term survival.
Cardiac disease is the single most important cause of deathamong patients receiving long-term dialysis therapy, accountingfor 44 percent of overall mortality.1 Approximately 22 percentof these deaths from cardiac causes are attributed to acutemyocardial infarction. For the period from 1993 through 1995,the adjusted overall death rate for patients on dialysis was243 deaths per 1000 patient-years.1 The risks of death fromcardiac causes and of death from all causes are higher amongolder patients, those with diabetic nephropathy, and those receivingperitoneal dialysis.1 Thus, there is an increasing burden ofcardiac disease in patients on long-term dialysis, since thegreatest increase in end-stage renal disease treated with dialysishas occurred in older patients and those with diabetic renalfailure. The mortality rate from 1993 through 1995 for patients65 years of age or more with diabetic end-stage renal diseasewas 368 deaths per 1000 patient-years, with cardiac diseaseaccounting for 46 percent of overall mortality.2 In 1995 approximately200,000 patients received dialysis in the United States; 18percent of them received peritoneal dialysis, and 82 percentreceived hemodialysis.3
Despite the burden of cardiac disease among patients on dialysis,there are no published data on their long-term survival afteracute myocardial infarction. The purpose of our study was toestimate the long-term survival of patients in the U.S. whowere receiving dialysis and who had acute myocardial infarction.Using the U.S. Renal Data System data base4 of 627,983 patients(approximately three fourths of whom were on dialysis and onefourth of whom were renal-transplant recipients), we examinedthe outcome after a first acute myocardial infarction for 34,189patients on long-term dialysis.
Methods
All data were derived from the U.S. Renal Data System, whichincludes data on approximately 92 percent of all patients undergoingdialysis in the United States.5 The accuracy of these data hasbeen validated previously.6
The study was a retrospective analysis of patients undergoingdialysis who were hospitalized for a first (index) acute myocardialinfarction that occurred after the initiation of renal-replacementtherapy from January 1977 to June 1995. The patients identifiedfrom the data base of 627,983 patients were those who had code410, 410.X, 410.X0, or 410.X1 of the International Classificationof Diseases, Ninth Revision, Clinical Modification (ICD-9-CM).7Eligible patients had received renal-replacement therapy fora total of at least 90 days and dialysis for at least 60 daysbefore having an acute myocardial infarction. Demographic dataon the patients included age, sex, race or ethnic group (Hispanicpatients were not identified in the data base), calendar yearof infarction, and primary renal diagnosis.
The effect of coexisting conditions was examined, since comorbiditysignificantly influences the survival of patients on dialysis.8,9,10We used a previously developed comorbidity-profiling methodbased on ICD-9-CM diagnosis and procedure codes in MedicarePart A institutional inpatient claims. Coexisting conditionswere identified by ICD-9-CM codes from hospitalizations thatoccurred before the index acute myocardial infarction. Coexistingconditions included congestive heart failure, other cardiacconditions (including valvular heart disease, implantation ofa pacemaker, and arrhythmia), cancers other than skin cancer,peripheral vascular disease, cerebrovascular ischemia (whichincluded cerebrovascular accident and transient ischemic attack),chronic obstructive pulmonary disease, gastrointestinal disease,gallbladder disease, and liver disease. Previous coronary revascularization(coronary bypass surgery or coronary angioplasty) was analyzedseparately in the Cox proportional-hazards model.
In-hospital mortality and the number of deaths per 1000 patient-yearswere estimated. Survival time was calculated from the date ofadmission to the hospital for acute myocardial infarction tothe date on which the data were censored or on which an endpoint (including in-hospital death) was reached. If a patienton dialysis had more than one infarction, the first was analyzedas the index event. The study end points were death from cardiaccauses and death from any cause (including early in-hospitaldeath). The data were censored if a patient underwent renaltransplantation, was still alive at the end of the study, orwas lost to follow-up.
Long-term survival and mortality were estimated by the life-tablemethod.11 The log-rank test was used to compare cumulative survivalin different groups. A Cox proportional-hazards model was usedto evaluate the effect of independent predictors (demographiccharacteristics, coexisting illnesses, and duration of end-stagerenal disease before acute myocardial infarction) on patients'survival.12 The reported P values in the Cox model are basedon the Wald test. All reported P values are two-sided. Statisticalanalyses were performed with use of the SAS system for Windows,version 6.12 (SAS Institute, Cary, N.C.).
A parallel survival analysis of renal-transplant recipientswith acute myocardial infarction was performed by the life-tablemethod. The survival of patients on dialysis was compared withthat of transplant recipients in a Cox model.
The Human Subject Research Committee of the Hennepin CountyMedical Center institutional review board approved this study.
Results
There were 34,189 patients on dialysis who had acute myocardialinfarction. The mean follow-up after myocardial infarction was1.16 years (interquartile range [25th to 75th percentile], 0.05to 1.59). There were 858 patients lost to follow-up.
Demographic Characteristics
Fifty-six percent of the group were men, and 44 percent werewomen. Eight percent were 44 years of age or less, 37 percentwere 45 to 64 years old, 35 percent were 65 to 74 years old,and 20 percent were 75 or more years old. Seventy-one percentwere white, 25 percent black, 1 percent Native American, 2 percentAsian, and 1 percent of other ethnic groups. The cause of renalfailure was diabetes in 34 percent, hypertension in 30 percent,and other conditions in 36 percent. Ten percent of acute myocardialinfarctions occurred from 1977 through 1984, 30 percent from1985 through 1989, and 60 percent from 1990 through 1995.
There were 3079 renal-transplant recipients with acute myocardialinfarction. For these patients, the mean follow-up after myocardialinfarction was 2.46 years. Seventy-two percent of the patientswere men, and 28 percent were women. Thirty-four percent were44 years of age or less, 55 percent were 45 to 64 years old,10 percent were 65 to 74 years old, and 1 percent were 75 ormore years old. Eighty-four percent were white, 14 percent wereblack, and 2 percent were of other races or ethnic groups. Thecause of renal failure was diabetes in 31 percent, hypertensionin 14 percent, and other conditions in 55 percent. Six percentof acute myocardial infarctions occurred from 1977 through 1984,30 percent from 1985 through 1989, and 64 percent from 1990through 1995.
We examined the temporal pattern of occurrence of acute myocardialinfarction in relation to the duration of dialysis. There appearedto be an early hazard of myocardial infarction related to theinitiation of dialysis, since 29 percent of infarctions occurredwithin one year and 52 percent within two years after the initiationof dialysis. In renal-transplant recipients, 15 percent of infarctionsoccurred within one year after transplantation and 29 percentwithin two years.
Mortality
Patients Undergoing Dialysis
The estimated in-hospital mortality for the entire cohort ofpatients on dialysis who had acute myocardial infarction was26 percent. Twenty-one percent of patients under 65 years ofage and 30 percent of those 65 or more years of age died inthe hospital. Twenty-seven percent of all patients with diabeticend-stage renal disease and 30 percent of those 65 or more yearsof age died in the hospital.
Table 1 summarizes the rates of death from all causes and fromcardiac causes according to age and cause of renal failure.An age of 65 years or more was a powerful predictor of deathafter acute myocardial infarction. Patients in this age groupwho had diabetic end-stage renal disease had an average lifeexpectancy of less than one year after myocardial infarction.
Table 1. Overall Rate of Death and Rate of Death from Cardiac Causes after Acute Myocardial Infarction among Patients on Dialysis, According to Age and Cause of Renal Failure, 1977 through 1995.
The curves for death from cardiac causes and death from allcauses are shown in Figure 1. Most patients on dialysis whohad acute myocardial infarctions ultimately died of heart disease.
Figure 1. Estimated Cumulative Mortality after Acute Myocardial Infarction among Patients on Dialysis.
The bars indicate standard errors.
Table 2 summarizes estimated long-term mortality from all causesand from heart disease according to renal diagnosis and theyear of occurrence of acute myocardial infarction. Patientson dialysis who had diabetic end-stage renal disease had thehighest mortality both overall and from cardiac causes. Surprisingly,the patients who had had acute myocardial infarctions most recently(between 1990 and 1995) had a higher overall rate of death fromall causes than those who had had myocardial infarctions between1977 and 1984 or between 1985 and 1989 (P<0.001). The trendswere similar for death from cardiac causes.
Table 2. Estimated Cumulative Overall Mortality and Mortality from Cardiac Causes after Acute Myocardial Infarction among Patients with End-Stage Renal Disease, According to Cause of Renal Failure and Year of Occurrence of Acute Myocardial Infarction.
The effects of independent predictors of overall mortality andmortality from cardiac causes were examined by the Cox proportional-hazardsmodel. Table 3 summarizes independent predictors of overallmortality. The most powerful predictors of overall mortalitywere older age and the presence of diabetic end-stage renaldisease. Coexisting noncardiac conditions (except gallbladderdisease) independently increased the risk of death by 10 to19 percent according to the Cox model. The duration of end-stagerenal disease, however, did not independently affect survival.Thus, the time from the initiation of dialysis to the indexacute myocardial infarction was not an independent predictorof survival. Previous coronary revascularization was associatedwith a 13 percent reduction in risk. Female sex was associatedwith a small survival advantage (relative risk of death, 0.96;95 percent confidence interval, 0.94 to 0.99). Race was a morepowerful predictor of survival, since nonwhite patients hadbetter outcomes. As compared with whites, black patients hada relative risk of death of 0.82 (95 percent confidence interval,0.80 to 0.85).
Table 3. Results of Cox Proportional-Hazards Model of Death from All Causes.
Table 4 summarizes independent predictors of mortality fromcardiac causes. Older age and the presence of diabetic end-stagerenal disease were the most powerful predictors of mortality,and noncardiac coexisting conditions had a small effect. Previouscongestive heart failure was associated with a relative riskof death from cardiac causes of 1.22 (95 percent confidenceinterval, 1.18 to 1.26). There was a reduced risk of death fromcardiac causes after myocardial infarction for women (relativerisk, 0.92; 95 percent confidence interval, 0.89 to 0.95). Racewas a predictor of improved survival for all nonwhite patientgroups. As compared with whites, black patients had a relativerisk of death from cardiac causes of 0.81 (95 percent confidenceinterval, 0.78 to 0.84). Previous coronary revascularizationwas associated with a 10 percent reduction in risk.
Table 4. Results of Cox Proportional-Hazards Model of Death from Cardiac Causes.
The somewhat counterintuitive effect on survival of the timeof occurrence of acute myocardial infarction is partly explainedby the Cox model. According to the Cox model, patients who hadmore recent myocardial infarctions (those occurring between1985 and 1989 or between 1990 and 1995) had better survivalthan those who had myocardial infarctions earlier (1977 to 1984).For patients with myocardial infarctions between 1990 and 1995,the relative risk of death from all causes was 0.87 (95 percentconfidence interval, 0.83 to 0.90) and that of death from cardiaccauses was 0.83 (95 percent confidence interval, 0.78 to 0.88).These results indicate that there has been a recent improvementin survival after adjustment is made for comorbidity.
Renal-Transplant Recipients
The estimated in-hospital mortality was 11.5 percent for theentire cohort of renal-transplant recipients. Table 2 includesselected mortality data for renal-transplant recipients withacute myocardial infarction.
Dialysis versus Transplantation
Large differences in mortality between patients on dialysisand renal-transplant recipients persisted after adjustment fordemographic characteristics, cause of renal failure, durationof end-stage renal disease, calendar year of occurrence of acutemyocardial infarction, and coexisting illnesses. The relativerisk of death from all causes for patients undergoing dialysisas compared with renal-transplant recipients was 2.74 (95 percentconfidence interval, 2.57 to 2.91). The relative risk of deathfrom cardiac causes was 4.45 (95 percent confidence interval,4.01 to 4.94). These results should be interpreted cautiously,because even after adjustment, patients undergoing dialysisand renal-transplant recipients may not be completely comparable.
Discussion
There are few data on long-term survival after acute myocardialinfarction among patients on dialysis. Two preliminary reportssuggested increased in-hospital mortality (29 percent and 33percent) for these patients.13,14 In this study we have shownthat acute myocardial infarction in patients on dialysis isa catastrophic event associated with dismal long-term survival.For the entire cohort of 34,189 patients on dialysis who hadacute myocardial infarctions from 1977 to 1995, only 41 percentof patients survived for one year and 27 percent for two years.Even more striking was the poor survival of patients treatedin the era of reperfusion. Patients who had acute myocardialinfarctions from 1990 to 1995 had overall mortality rates of61 percent at one year and 74 percent at two years. The two-yearmortality from cardiac causes was about 50 percent in patientswho had acute myocardial infarctions from 1977 to 1984 and 52percent for those who had acute myocardial infarctions from1990 to 1995. The high mortality from cardiac disease and evenhigher overall mortality probably reflect the effects of coexistingconditions,8,15 but it is unclear how much of the differenceof approximately 20 percentage points between overall mortalityand mortality from cardiac causes at two years is attributableto coexisting conditions. The persistently poor outcomes overtime mask a small improvement in survival adjusted for comorbidityin the Cox model. There was a 13 percent reduction in the riskof death from all causes and a 17 percent reduction in the riskof death from cardiac causes in 1990 to 1995, as compared with1977 to 1984. This masking is explainable by the increase inthe proportion of older patients and patients with diabetesover time, which contributed to increased mortality.
The survival of patients on dialysis who had acute myocardialinfarctions is considerably worse than would be expected onthe basis of other published reports of patients without end-stagerenal disease who had acute myocardial infarctions, includingpatients with other coexisting conditions. The most powerfulindependent predictors of overall mortality and mortality fromcardiac causes in our study were older age and diabetic nephropathy,but even patients with end-stage renal disease that was notdue to diabetes or hypertension had poor outcomes, with a 31percent two-year survival (69 percent overall mortality). Indiabetic patients without end-stage renal disease who had acutemyocardial infarction, a one-year survival of 80 percent16 anda 19-month survival of 75 percent17 were reported in the erabefore reperfusion therapy became common.
In the Minnesota Heart Survey, the in-hospital case fatalityrate in 1985 for patients with diabetes who had acute myocardialinfarction was 18 percent in men and 16 percent in women.18Over the period from 1970 to 1985, about three fourths of diabeticmen and two thirds of diabetic women who were discharged afteran acute myocardial infarction were still alive two years later.18In the Worcester Heart Attack Study, the overall in-hospitalcase fatality rate after myocardial infarction was 22 percentfor diabetic patients for the period from 1975 to 1986. Approximatelythree fourths of diabetic men and two thirds of diabetic womendischarged after an acute myocardial infarction were still alivetwo years later.19 In the Minnesota Heart Survey, the three-yearsurvival rate after acute myocardial infarction ranged from63.5 percent to 73.1 percent for men and from 60.6 percent to66.9 percent for women from 1970 to 1985,20 with an additionalreduction in mortality in 1990.21 In the present study, 60 percentof all patients on dialysis between 1990 and 1995 had acutemyocardial infarctions. The substantial reduction in mortalityfrom acute myocardial infarction over time that was observedin the Minnesota Heart Survey has not been mirrored in the populationundergoing dialysis.
There appears to be greater mortality from cardiac causes andgreater overall mortality among patients on dialysis who haveacute myocardial infarctions than among another cohort of patientswith end-stage renal disease, renal-transplant recipients whohave myocardial infarctions. The two-year mortality from cardiaccauses of 11.4 percent and overall mortality of 30.4 percentin the renal-transplant cohort are more favorable than the two-yearmortality from cardiac causes of 51.8 percent and overall mortalityof 73.0 percent among the patients undergoing dialysis. Thisdifference in mortality is apparent at all times from 1 to 10years.
Our finding that mortality after acute myocardial infarctionamong patients on dialysis is lower for blacks than for whitesis consistent with previously published data on the survivalof patients on dialysis. In 1984 the one-year death rate ofwhite patients on dialysis was higher than that of black patientsby 13 deaths per 100 patient-years.22 By 1994 this differencehad narrowed to 5 deaths per 100 patient-years.22 Bloembergenet al.23 reported that white patients had a 29 percent higherrisk of death than blacks and that whites were 34 percent morelikely to die of myocardial infarction. In the present study,the overall risk of death after myocardial infarction for patientson dialysis was 18 percent lower for blacks than for whites,and the risk of death from cardiac disease was 19 percent lower.
We found a small advantage in terms of survival after acutemyocardial infarction associated with female sex, with a 4 percentreduction in overall mortality and an 8 percent reduction inmortality due to cardiac disease. Although female sex has usuallybeen associated with higher mortality from acute myocardialinfarction among patients without end-stage renal disease, arecent study disputes earlier reports of excess early mortalityin women.24
Our data suggest that there is an early risk of acute myocardialinfarction associated with the initiation of dialysis, with29 percent of infarctions occurring within one year and 52 percentoccurring within two years after the initiation of dialysis.Usually patients with end-stage renal disease are evaluatedfor risk of cardiac events only when they are being consideredfor renal transplantation. We suggest that an evaluation forcardiac risk be considered for such patients at the initiationof dialysis.
There are several limitations to our study. The primary sourceof the U.S. Renal Data System data was Medicare claims data,which may be subject to inaccuracies in the diagnosis of acutemyocardial infarction. After comparing claims data with medical-chart(clinical) data in a study of 12,937 patients undergoing inpatientcardiac catheterization, Jollis et al.25 found an 88 percentrate of agreement between claims data and clinical data withrespect to the ICD-9-CM code for acute myocardial infarction(410), with a specificity of 95 percent.25 We undoubtedly missedsome patients with acute myocardial infarction, since Jolliset al. found that claims data had 76 percent sensitivity ascompared with clinical data for the diagnosis of acute myocardialinfarction.25
Two aspects of our methods may have led to an underestimationof mortality. Our survival analysis ignored out-of-hospitaldeaths from acute myocardial infarction and those occurringless than 60 days after the initiation of dialysis. The issueof "missed" or "uncounted" acute myocardial infarctions makesaccurate estimation of the incidence of acute myocardial infarctiondifficult, but our data indicate that in 1995 there were atleast 5000 first-time infarctions after the initiation of dialysis,with 1300 in-hospital deaths, in a population of 200,000 patientson dialysis. The total number of acute myocardial infarctionsand resulting in-hospital deaths may be considerably larger,since in our study, survival analysis was restricted to thefirst (index) acute myocardial infarction. On the basis of datafrom the U.S. Renal Data System, approximately 4600 deaths peryear (not restricted to in-hospital deaths) in 200,000 patientson dialysis are attributed to acute myocardial infarction.1The principal weakness of the data base is that it providesfew clinical data. Therefore, important prognostic factors,such as the left ventricular ejection fraction and hemodynamicdata, were not available for our study.
The present study does not explain the persistence of poor survivalrates after acute myocardial infarction over time, even in thereperfusion era. Preliminary data from an ongoing study suggestthat thrombolytic therapy is underused in the treatment of patientson dialysis who have acute myocardial infarction,26 but thereare no published data on the survival of patients on dialysiswho receive reperfusion therapy for acute myocardial infarction.
We conclude that patients on dialysis who have acute myocardialinfarction have high rates of death from cardiac causes andpoor long-term survival. Our data provide support for the developmentof more aggressive strategies for the prevention and treatmentof acute myocardial infarction in patients on dialysis.
Supported by a grant (1 RO1 DK 49540) from the National Instituteof Diabetes and Digestive and Kidney Diseases, Bethesda, Md.
The data reported here have been supplied by the U.S. RenalData System. The interpretation and reporting of these dataare the responsibility of the authors and in no way should beseen as an official policy or interpretation of the U.S. government.
Source Information
From the Divisions of Cardiology (C.A.H.) and Nephrology (J.Z.M., A.J.C.), Department of Internal Medicine, Hennepin County Medical Center and University of Minnesota, Minneapolis.
Address reprint requests to Dr. Herzog at the Hennepin County Medical Center, 701 Park Ave., Minneapolis, MN 55415.
References
Renal Data System. USRDS 1997 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, April 1997:91-101. (NIH publication no. 97-3176.)
Renal Data System. USRDS 1997 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, April 1997:D1-D51. (NIH publication no. 97-3176.)
Renal Data System. USRDS 1997 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, April 1997:35-47. (NIH publication no. 97-3176.)
Renal Data System. USRDS 1997 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, April 1997:C1-C41. (NIH publication no. 97-3176.)
Renal Data System. USRDS 1997 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, April 1997:21-48. (NIH publication no. 97-3176.)
Renal Data System. USRDS 1992 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, August 1992:61-82. (NIH publication no. 92-3176.)
Puckett CD. The educational annotation of ICD-9-CM. 4th ed. 6th printing. Vols. 1, 2, 3. Reno, Nev.: Channel Publishing, 1997.
Keane WF, Collins AJ. Influence of co-morbidity on mortality and morbidity in patients treated with hemodialysis. Am J Kidney Dis 1994;24:1010-1018. [Medline]
Gaylin DS, Held PJ, Port FK. The impact of comorbid and sociodemographic factors on access to renal transplantation. JAMA 1993;269:603-608. [Free Full Text]
Held PJ, Port FK, Gaylin DS, et al. Evaluations of initial predictors of mortality among 4387 new ESRD patients: the USRDS case mix study. J Am Soc Nephrol 1991;2:328-328.abstract
Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457-81.
Cox DR. Regression models and life-tables. J R Stat Soc [B] 1972;34:187-202.
Rubin TA, Thielen KA, Collins AJ, Herzog CA. Acute myocardial infarction in chronic dialysis patients. J Am Coll Cardiol 1996;27:Suppl A:67A-67A.abstract
Kong TQ, Dacanay S, Hsieh AA. Features of acute myocardial infarction in patients on chronic hemodialysis. Circulation 1993;88:Suppl I:I-49.abstract
Collins AJ, Hanson G, Umen A, Kjellstrand C, Keshaviah P. Changing risk factor demographics in end-stage renal disease patients entering hemodialysis and the impact on long-term mortality. Am J Kidney Dis 1990;25:422-432.
Nicod P, Gilipin E, Dittrich H, et al. Short- and long-term clinical outcome after Q wave and non-Q wave myocardial infarction in a large patient population. Circulation 1989;79:528-536. [Free Full Text]
Smith JW, Marcus FI, Serokman R. Prognosis of patients with diabetes mellitus after acute myocardial infarction. Am J Cardiol 1984;54:718-721. [CrossRef][Medline]
Sprafka JM, Burke GL, Folsom AR, McGovern PG, Hahn LP. Trends in prevalence of diabetes mellitus in patients with myocardial infarction and effect of diabetes on survival: the Minnesota Heart Survey. Diabetes Care 1991;14:537-543. [Abstract]
Donahue RP, Goldberg RJ, Chen Z, Gore JM, Alpert JS. The influence of sex and diabetes mellitus on survival following acute myocardial infarction: a community-wide perspective. J Clin Epidemiol 1993;46:245-252. [CrossRef][Medline]
McGovern PG, Folsom AR, Sprafka JM, et al. Trends in survival of hospitalized myocardial infarction patients between 1970 and 1985: the Minnesota Heart Survey. Circulation 1992;85:172-179. [Free Full Text]
McGovern PG, Pankow JS, Shahar E, et al. Recent trends in acute coronary heart disease: mortality, morbidity, medical care, and risk factors. N Engl J Med 1996;334:884-890. [Free Full Text]
Renal Data System. USRDS 1997 annual data report. Bethesda, Md.: National Institute of Diabetes and Digestive and Kidney Diseases, April 1997:69-89. (NIH publication no. 97-3176.)
Bloembergen WE, Port FK, Mauger EA, Wolfe RA. Causes of death in dialysis patients: racial and gender differences. J Am Soc Nephrol 1994;5:1231-1242. [Abstract]
Malacrida R, Genoni M, Maggioni AP, et al. A comparison of the early outcome of acute myocardial infarction in women and men. N Engl J Med 1998;338:8-14. [Free Full Text]
Jollis JG, Ancukiewicz M, DeLong ER, Pryor DB, Muhlbaier LH, Mark DB. Discordance of databases designed for claims payment versus clinical information systems: implications for outcomes research. Ann Intern Med 1993;119:844-850. [Free Full Text]
Herzog CA, Ma J, Collins AJ. Outcome of dialysis patients receiving thrombolytic therapy for acute myocardial infarction (AMI) in the United States. Circulation 1997;96:Suppl I:I-202.abstract
Schlaich, M. P., Socratous, F., Hennebry, S., Eikelis, N., Lambert, E. A., Straznicky, N., Esler, M. D., Lambert, G. W.
(2009). Sympathetic Activation in Chronic Renal Failure. J. Am. Soc. Nephrol.
20: 933-939
[Abstract][Full Text]
Jaroszynski, A., Czekajska-Chechab, E., Drelich-Zbroja, A., Zapolski, T., Ksiazek, A.
(2009). Spatial QRS-T angle in peritoneal dialysis patients: association with carotid artery atherosclerosis, coronary artery calcification and troponin T. Nephrol Dial Transplant
24: 1003-1008
[Abstract][Full Text]
Krane, V., Heinrich, F., Meesmann, M., Olschewski, M., Lilienthal, J., Angermann, C., Stork, S., Bauersachs, J., Wanner, C., Frantz, S., for the German Diabetes and Dialysis Study Investi,
(2009). Electrocardiography and Outcome in Patients with Diabetes Mellitus on Maintenance Hemodialysis. CJASN
4: 394-400
[Abstract][Full Text]
Trivedi, H., Xiang, Q., Klein, J. P.
(2009). Risk factors for non-fatal myocardial infarction and cardiac death in incident dialysis patients. Nephrol Dial Transplant
24: 258-266
[Abstract][Full Text]
Tsagalis, G., Akrivos, T., Alevizaki, M., Manios, E., Stamatellopoulos, K., Laggouranis, A., Vemmos, K. N.
(2009). Renal dysfunction in acute stroke: an independent predictor of long-term all combined vascular events and overall mortality. Nephrol Dial Transplant
24: 194-200
[Abstract][Full Text]
Berger, P. B., Best, P. J.M.
(2009). Does Kidney Function Alter the Benefit of Reperfusion Therapy for ST-Segment Elevation Myocardial Infarction?. J Am Coll Cardiol Intv
2: 34-36
[Full Text]
Amann, K.
(2008). Media Calcification and Intima Calcification Are Distinct Entities in Chronic Kidney Disease. CJASN
3: 1599-1605
[Abstract][Full Text]
Hayashi, T., Obi, Y., Kimura, T., Iio, K.-i., Sumitsuji, S., Takeda, Y., Nagai, Y., Imai, E.
(2008). Cardiac troponin T predicts occult coronary artery stenosis in patients with chronic kidney disease at the start of renal replacement therapy. Nephrol Dial Transplant
23: 2936-2942
[Abstract][Full Text]
Rabkin, R., Awwad, I., Chen, Y., Ashley, E. A., Sun, D., Sood, S., Clusin, W., Heidenreich, P., Piecha, G., Gross, M.-L.
(2008). Low-Dose Growth Hormone is Cardioprotective in Uremia. J. Am. Soc. Nephrol.
19: 1774-1783
[Abstract][Full Text]
Johnston, N., Dargie, H., Jardine, A.
(2008). Diagnosis and treatment of coronary artery disease in patients with chronic kidney disease. Heart
94: 1080-1088
[Full Text]
Goldenberg, I., Vyas, A. K., Hall, W. J., Moss, A. J., Wang, H., He, H., Zareba, W., McNitt, S., Andrews, M. L., for the MADIT-II Investigators,
(2008). Risk Stratification for Primary Implantation of a Cardioverter-Defibrillator in Patients With Ischemic Left Ventricular Dysfunction. J Am Coll Cardiol
51: 288-296
[Abstract][Full Text]
Herzog, C. A.
(2008). Kidney disease in cardiology. Nephrol Dial Transplant
23: 42-46
[Abstract][Full Text]
Banerjee, D., Ma, J. Z., Collins, A. J., Herzog, C. A.
(2007). Long-Term Survival of Incident Hemodialysis Patients Who Are Hospitalized for Congestive Heart Failure, Pulmonary Edema, or Fluid Overload. CJASN
2: 1186-1190
[Abstract][Full Text]
Tanaka, Y., Joki, N., Hase, H.
(2007). History of acute coronary events during the predialysis phase of chronic kidney disease is a strong risk factor for major adverse cardiac events in patients initiating haemodialysis. Nephrol Dial Transplant
22: 2917-2923
[Abstract][Full Text]
Herzog, C. A., Littrell, K., Arko, C., Frederick, P. D., Blaney, M.
(2007). Clinical Characteristics of Dialysis Patients With Acute Myocardial Infarction in the United States: A Collaborative Project of the United States Renal Data System and the National Registry of Myocardial Infarction. Circulation
116: 1465-1472
[Abstract][Full Text]
Taneja, S., Mandayam, S., Kayani, Z. Z., Kuo, Y.-F., Shahinian, V. B.
(2007). Comparison of Stage at Diagnosis of Cancer in Patients Who Are on Dialysis versus the General Population. CJASN
2: 1008-1013
[Abstract][Full Text]
Schiffrin, E. L., Lipman, M. L., Mann, J. F.E.
(2007). Chronic Kidney Disease: Effects on the Cardiovascular System. Circulation
116: 85-97
[Abstract][Full Text]
John, R., Lietz, K., Huddleston, S., Matas, A., Liao, K., Shumway, S., Joyce, L., Bolman, R. M.
(2007). Perioperative outcomes of cardiac surgery in kidney and kidney pancreas transplant recipients. J. Thorac. Cardiovasc. Surg.
133: 1212-1219
[Abstract][Full Text]
Sharma, R., Chemla, E., Tome, M., Mehta, R. L, Gregson, H., Brecker, S. J D, Chang, R., Pellerin, D.
(2007). Echocardiography-based score to predict outcome after renal transplantation. Heart
93: 464-469
[Abstract][Full Text]
Edwards, N.C., Steeds, R.P., Ferro, C.J., Townend, J.N.
(2006). The treatment of coronary artery disease in patients with chronic kidney disease. QJM
99: 723-736
[Abstract][Full Text]
Rakhit, D J, Marwick, T H, Armstrong, K A, Johnson, D W, Leano, R, Isbel, N M
(2006). Effect of aggressive risk factor modification on cardiac events and myocardial ischaemia in patients with chronic kidney disease. Heart
92: 1402-1408
[Abstract][Full Text]
Jose, P., Skali, H., Anavekar, N., Tomson, C., Krumholz, H. M., Rouleau, J. L., Moye, L., Pfeffer, M. A., Solomon, S. D., for the SAVE Investigators,
(2006). Increase in Creatinine and Cardiovascular Risk in Patients with Systolic Dysfunction after Myocardial Infarction. J. Am. Soc. Nephrol.
17: 2886-2891
[Abstract][Full Text]
Yoshida, H., Yokoyama, K., Maruvama, Y., Yamanoto, H., Yoshida, S., Hosoya, T.
(2006). Investigation of coronary artery calcification and stenosis by coronary angiography (CAG) in haemodialysis patients. Nephrol Dial Transplant
21: 1451-1452
[Full Text]
Kutner, N. G., Zhang, R., Huang, Y., Herzog, C. A.
(2006). Cardiac Rehabilitation and Survival of Dialysis Patients after Coronary Bypass. J. Am. Soc. Nephrol.
17: 1175-1180
[Abstract][Full Text]
Dewey, T. M., Herbert, M. A., Prince, S. L., Robbins, C. L., Worley, C. M., Magee, M. J., Mack, M. J.
(2006). Does Coronary Artery Bypass Graft Surgery Improve Survival Among Patients With End-Stage Renal Disease?. Ann. Thorac. Surg.
81: 591-598
[Abstract][Full Text]
Berl, T., Henrich, W.
(2006). Kidney-Heart Interactions: Epidemiology, Pathogenesis, and Treatment. CJASN
1: 8-18
[Full Text]
Khan, N. A., Ma, I., Thompson, C. R., Humphries, K., Salem, D. N., Sarnak, M. J., Levin, A.
(2006). Kidney Function and Mortality among Patients with Left Ventricular Systolic Dysfunction. J. Am. Soc. Nephrol.
17: 244-253
[Abstract][Full Text]
Tonelli, M., Keech, A., Shepherd, J., Sacks, F., Tonkin, A., Packard, C., Pfeffer, M., Simes, J., Isles, C., Furberg, C., West, M., Craven, T., Curhan, G.
(2005). Effect of Pravastatin in People with Diabetes and Chronic Kidney Disease. J. Am. Soc. Nephrol.
16: 3748-3754
[Abstract][Full Text]
Shlipak, M., Stehman-Breen, C.
(2005). Observational Research Databases in Renal Disease. J. Am. Soc. Nephrol.
16: 3477-3484
[Abstract][Full Text]
Lauer, M. S.
(2005). Cardiac Troponins and Renal Failure: The Evolution of a Clinical Test. Circulation
112: 3036-3037
[Full Text]
Khan, N. A., Hemmelgarn, B. R., Tonelli, M., Thompson, C. R., Levin, A.
(2005). Prognostic Value of Troponin T and I Among Asymptomatic Patients With End-Stage Renal Disease: A Meta-Analysis. Circulation
112: 3088-3096
[Abstract][Full Text]
Nolan, C. R.
(2005). Strategies for Improving Long-Term Survival in Patients with ESRD. J. Am. Soc. Nephrol.
16: S120-S127
[Abstract][Full Text]
Holzmann, M. J., Ahnve, S., Hammar, N., Jorgensen, L., Klerdal, K., Pehrsson, K., Ivert, T.
(2005). Creatinine clearance and risk of early mortality in patients undergoing coronary artery bypass grafting. J. Thorac. Cardiovasc. Surg.
130: 746-746
[Abstract][Full Text]
Fragedaki, E., Nebel, M., Schupp, N., Sebekova, K., Volkel, W., Klassen, A., Pischetsrieder, M., Frischmann, M., Niwa, T., Vienken, J., Heidland, A., Stopper, H.
(2005). Genomic damage and circulating AGE levels in patients undergoing daily versus standard haemodialysis. Nephrol Dial Transplant
20: 1936-1943
[Abstract][Full Text]
Massad, M. G., Kpodonu, J., Lee, J., Espat, J., Gandhi, S., Tevar, A., Geha, A. S.
(2005). Outcome of Coronary Artery Bypass Operations in Patients With Renal Insufficiency With and Without Renal Transplantation. Chest
128: 855-862
[Abstract][Full Text]
Vanholder, R., Massy, Z., Argiles, A., Spasovski, G., Verbeke, F., Lameire, N., for the European Uremic Toxin Work Group (EUTox),
(2005). Chronic kidney disease as cause of cardiovascular morbidity and mortality. Nephrol Dial Transplant
20: 1048-1056
[Abstract][Full Text]
de Araujo Goncalves, P., Ferreira, J., Aguiar, C., Seabra-Gomes, R.
(2005). TIMI, PURSUIT, and GRACE risk scores: sustained prognostic value and interaction with revascularization in NSTE-ACS. Eur Heart J
26: 865-872
[Abstract][Full Text]
Parekh, R. S., Zhang, L., Fivush, B. A., Klag, M. J.
(2005). Incidence of Atherosclerosis by Race in the Dialysis Morbidity and Mortality Study: A Sample of the US ESRD Population. J. Am. Soc. Nephrol.
16: 1420-1426
[Abstract][Full Text]
Ohtake, T., Kobayashi, S., Moriya, H., Negishi, K., Okamoto, K., Maesato, K., Saito, S.
(2005). High Prevalence of Occult Coronary Artery Stenosis in Patients with Chronic Kidney Disease at the Initiation of Renal Replacement Therapy: An Angiographic Examination. J. Am. Soc. Nephrol.
16: 1141-1148
[Abstract][Full Text]
van de Wal, R. M.A., van Brussel, B. L., Voors, A. A., Smilde, T. D.J., Kelder, J. C., van Swieten, H. A., van Gilst, W. H., van Veldhuisen, D. J., Plokker, H.W. T.
(2005). Mild preoperative renal dysfunction as a predictor of long-term clinical outcome after coronary bypass surgery. J. Thorac. Cardiovasc. Surg.
129: 330-335
[Abstract][Full Text]
Lentine, K. L., Brennan, D. C., Schnitzler, M. A.
(2005). Incidence and Predictors of Myocardial Infarction after Kidney Transplantation. J. Am. Soc. Nephrol.
16: 496-506
[Abstract][Full Text]
Bongartz, L. G., Cramer, M. J., Doevendans, P. A., Joles, J. A., Braam, B.
(2005). The severe cardiorenal syndrome: 'Guyton revisited'. Eur Heart J
26: 11-17
[Abstract][Full Text]
Tokmakova, M. P., Skali, H., Kenchaiah, S., Braunwald, E., Rouleau, J. L., Packer, M., Chertow, G. M., Moye, L. A., Pfeffer, M. A., Solomon, S. D.
(2004). Chronic Kidney Disease, Cardiovascular Risk, and Response to Angiotensin-Converting Enzyme Inhibition After Myocardial Infarction: The Survival And Ventricular Enlargement (SAVE) Study. Circulation
110: 3667-3673
[Abstract][Full Text]
Herzog, C. A.
(2004). Don't forget the defibrillator in the dialysis unit. Nephrol Dial Transplant
19: 2959-2960
[Full Text]
Marenzi, G., Lauri, G., Assanelli, E., Campodonico, J., De Metrio, M., Marana, I., Grazi, M., Veglia, F., Bartorelli, A. L.
(2004). Contrast-induced nephropathy in patients undergoing primary angioplasty for acute myocardial infarction. J Am Coll Cardiol
44: 1780-1785
[Abstract][Full Text]
Gupta, R., Birnbaum, Y., Uretsky, B. F.
(2004). The renal patient with coronary artery disease: Current concepts and dilemmas. J Am Coll Cardiol
44: 1343-1353
[Abstract][Full Text]
Trachiotis, G. D., Hanumara, D., McKenna, L., Corso, P., Pfister, A.
(2004). Surgical revascularization after acute myocardial infarction in patients with end-stage renal disease. Eur. J. Cardiothorac. Surg.
26: 671-675
[Abstract][Full Text]
Koch, M., Trapp, R., Kulas, W., Grabensee, B.
(2004). Critical limb ischaemia as a main cause of death in patients with end-stage renal disease: a single-centre study. Nephrol Dial Transplant
19: 2547-2552
[Abstract][Full Text]
Anavekar, N. S., McMurray, J. J.V., Velazquez, E. J., Solomon, S. D., Kober, L., Rouleau, J.-L., White, H. D., Nordlander, R., Maggioni, A., Dickstein, K., Zelenkofske, S., Leimberger, J. D., Califf, R. M., Pfeffer, M. A.
(2004). Relation between Renal Dysfunction and Cardiovascular Outcomes after Myocardial Infarction. NEJM
351: 1285-1295
[Abstract][Full Text]
Tonelli, M., Isles, C., Curhan, G. C., Tonkin, A., Pfeffer, M. A., Shepherd, J., Sacks, F. M., Furberg, C., Cobbe, S. M., Simes, J., Craven, T., West, M.
(2004). Effect of Pravastatin on Cardiovascular Events in People With Chronic Kidney Disease. Circulation
110: 1557-1563
[Abstract][Full Text]
Mueller, C, Neumann, F-J, Perruchoud, A P, Buettner, H J
(2004). Renal function and long term mortality after unstable angina/non-ST segment elevation myocardial infarction treated very early and predominantly with percutaneous coronary intervention. Heart
90: 902-907
[Abstract][Full Text]
Herzog, C. A., Ma, J. Z., Collins, A. J.
(2004). Long-Term Outcome of Renal Transplant Recipients in the United States After Coronary Revascularization Procedures. Circulation
109: 2866-2871
[Abstract][Full Text]
Dikow, R., Kihm, L. P., Zeier, M., Kapitza, J., Tornig, J., Amann, K., Tiefenbacher, C., Ritz, E.
(2004). Increased Infarct Size in Uremic Rats: Reduced Ischemia Tolerance?. J. Am. Soc. Nephrol.
15: 1530-1536
[Abstract][Full Text]
Okubo, K., Ikewaki, K., Sakai, S., Tada, N., Kawaguchi, Y., Mochizuki, S.
(2004). Abnormal HDL Apolipoprotein A-I and A-II Kinetics in Hemodialysis Patients: A Stable Isotope Study. J. Am. Soc. Nephrol.
15: 1008-1015
[Abstract][Full Text]
Beddhu, S., Pappas, L. M., Ramkumar, N., Samore, M. H.
(2004). Malnutrition and Atherosclerosis in Dialysis Patients. J. Am. Soc. Nephrol.
15: 733-742
[Abstract][Full Text]
Mitchell, G. F.
(2004). Increased Aortic Stiffness: An Unfavorable Cardiorenal Connection. Hypertension
43: 151-153
[Full Text]
Trovati, M., Cavalot, F.
(2004). Optimization of Hypolipidemic and Antiplatelet Treatment in the Diabetic Patient with Renal Disease. J. Am. Soc. Nephrol.
15: S12-20
[Abstract][Full Text]
Locatelli, F., Pozzoni, P., Del Vecchio, L.
(2004). Renal Replacement Therapy in Patients with Diabetes and End-Stage Renal Disease. J. Am. Soc. Nephrol.
15: S25-29
[Abstract][Full Text]
Sadeghi, H. M., Stone, G. W., Grines, C. L., Mehran, R., Dixon, S. R., Lansky, A. J., Fahy, M., Cox, D. A., Garcia, E., Tcheng, J. E., Griffin, J. J., Stuckey, T. D., Turco, M., Carroll, J. D.
(2003). Impact of Renal Insufficiency in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction. Circulation
108: 2769-2775
[Abstract][Full Text]
French, W. J., Wright, R. S.
(2003). Renal insufficiency and worsened prognosis with STEMI: A call for action. J Am Coll Cardiol
42: 1544-1546
[Full Text]
Sarnak, M. J., Levey, A. S., Schoolwerth, A. C., Coresh, J., Culleton, B., Hamm, L. L., McCullough, P. A., Kasiske, B. L., Kelepouris, E., Klag, M. J., Parfrey, P., Pfeffer, M., Raij, L., Spinosa, D. J., Wilson, P. W.
(2003). Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension
42: 1050-1065
[Full Text]
Sarnak, M. J., Levey, A. S., Schoolwerth, A. C., Coresh, J., Culleton, B., Hamm, L. L., McCullough, P. A., Kasiske, B. L., Kelepouris, E., Klag, M. J., Parfrey, P., Pfeffer, M., Raij, L., Spinosa, D. J., Wilson, P. W.
(2003). Kidney Disease as a Risk Factor for Development of Cardiovascular Disease: A Statement From the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Circulation
108: 2154-2169
[Full Text]
Dikow, R., Ritz, E.
(2003). Cardiovascular complications in the diabetic patient with renal disease: an update in 2003. Nephrol Dial Transplant
18: 1993-1998
[Full Text]
Ashman, N., Macey, M. G., Fan, S. L., Azam, U., Yaqoob, M. M.
(2003). Increased platelet-monocyte aggregates and cardiovascular disease in end-stage renal failure patients. Nephrol Dial Transplant
18: 2088-2096
[Abstract][Full Text]
Cooper, W. A., Brinkman, W., Petersen, R. J., Guyton, R. A.
(2003). Impact of renal disease in cardiovascular surgery: emphasis on the African-American patient. Ann. Thorac. Surg.
76: S1370-1376
[Abstract][Full Text]
Herzog, C. A.
(2003). How to Manage the Renal Patient with Coronary Heart Disease: The Agony and the Ecstasy of Opinion-Based Medicine. J. Am. Soc. Nephrol.
14: 2556-2572
[Full Text]
Wong, D., Thompson, G., Buth, K., Sullivan, J., Ali, I.
(2003). Angiographic coronary diffuseness and outcomes in dialysis patients undergoing coronary artery bypass grafting surgery. Eur. J. Cardiothorac. Surg.
24: 388-392
[Abstract][Full Text]
Levin, A.
(2003). The advantage of a uniform terminology and staging system for chronic kidney disease (CKD). Nephrol Dial Transplant
18: 1446-1451
[Full Text]
Levin, A.
(2003). The advantage of a uniform terminology and staging system for chronic kidney disease (CKD). Nephrol Dial Transplant
18: 1446-1451
[Full Text]
Berger, A. K., Duval, S., Krumholz, H. M.
(2003). Aspirin, beta-blocker, and angiotensin-converting enzyme inhibitor therapy in patients with end-stage renal disease and an acute myocardial infarction. J Am Coll Cardiol
42: 201-208
[Abstract][Full Text]
Reddan, D. N., Klassen, P. S., Szczech, L. A., Coladonato, J. A., O'Shea, S., Owen, W. F. Jr, Lowrie, E. G.
(2003). White blood cells as a novel mortality predictor in haemodialysis patients. Nephrol Dial Transplant
18: 1167-1173
[Abstract][Full Text]
Amann, K., Ritz, C., Adamczak, M., Ritz, E.
(2003). Why is coronary heart disease of uraemic patients so frequent and so devastating?. Nephrol Dial Transplant
18: 631-640
[Abstract][Full Text]
Freeman, R. V., Mehta, R. H., Al Badr, W., Cooper, J. V., Kline-Rogers, E., Eagle, K. A.
(2003). Influence of concurrent renal dysfunction on outcomes of patients with acute coronary syndromes and implications of the use of glycoprotein IIb/IIIa inhibitors. J Am Coll Cardiol
41: 718-724
[Abstract][Full Text]
Tepel, M., van der Giet, M., Statz, M., Jankowski, J., Zidek, W.
(2003). The Antioxidant Acetylcysteine Reduces Cardiovascular Events in Patients With End-Stage Renal Failure: A Randomized, Controlled Trial. Circulation
107: 992-995
[Abstract][Full Text]
Rabbat, C. G., Treleaven, D. J., Russell, J. D., Ludwin, D., Cook, D. J.
(2003). Prognostic Value of Myocardial Perfusion Studies in Patients with End-Stage Renal Disease Assessed for Kidney or Kidney-Pancreas Transplantation: A Meta-Analysis. J. Am. Soc. Nephrol.
14: 431-439
[Abstract][Full Text]
McCullough, P. A., Nowak, R. M., Foreback, C., Tokarski, G., Tomlanovich, M. C., Khoury, N., Weaver, W. D., Sandberg, K. R., McCord, J.
(2002). Emergency Evaluation of Chest Pain in Patients With Advanced Kidney Disease. Arch Intern Med
162: 2464-2468
[Abstract][Full Text]
Herzog, C. A., Ma, J. Z., Collins, A. J.
(2002). Comparative Survival of Dialysis Patients in the United States After Coronary Angioplasty, Coronary Artery Stenting, and Coronary Artery Bypass Surgery and Impact of Diabetes. Circulation
106: 2207-2211
[Abstract][Full Text]
Chow, K. M., Szeto, C. C., Wong, T. Y.-h., Leung, F. K.-t., Cheuk, A., Li, P. K.-t.
(2002). Diabetic Muscle Infarction: Myocardial infarct equivalent. Diabetes Care
25: 1895-1895
[Full Text]
Shlipak, M. G., Heidenreich, P. A., Noguchi, H., Chertow, G. M., Browner, W. S., McClellan, M. B.
(2002). Association of Renal Insufficiency with Treatment and Outcomes after Myocardial Infarction in Elderly Patients. ANN INTERN MED
137: 555-562
[Abstract][Full Text]
Wright, R. S., Reeder, G. S., Herzog, C. A., Albright, R. C., Williams, B. A., Dvorak, D. L., Miller, W. L., Murphy, J. G., Kopecky, S. L., Jaffe, A. S.
(2002). Acute Myocardial Infarction and Renal Dysfunction: A High-Risk Combination. ANN INTERN MED
137: 563-570
[Abstract][Full Text]
Townsend, R. R.
(2002). Cardiac Mortality in Chronic Kidney Disease: A Clearer Perspective. ANN INTERN MED
137: 615-616
[Full Text]
McCullough, P. A, Sandberg, K. R, Yee, J., Hudson, M. P
(2002). Mortality benefit of angiotensin-converting enzyme inhibitors after cardiac events in patients with end-stage renal disease. Journal of Renin-Angiotensin-Aldosterone System
3: 188-191
[Abstract]
Al Suwaidi, J., Reddan, D. N., Williams, K., Pieper, K. S., Harrington, R. A., Califf, R. M., Granger, C. B., Ohman, E. M., Holmes, D. R. Jr, for the GUSTO-IIb, GUSTO-III, PURSUIT, and PARAGON,
(2002). Prognostic Implications of Abnormalities in Renal Function in Patients With Acute Coronary Syndromes. Circulation
106: 974-980
[Abstract][Full Text]
Dacey, L. J., Liu, J. Y., Braxton, J. H., Weintraub, R. M., DeSimone, J., Charlesworth, D. C., Lahey, S. J., Ross, C. S., Hernandez, F. Jr, Leavitt, B. J., O'Connor, G. T.
(2002). Long-term survival of dialysis patients after coronary bypass grafting. Ann. Thorac. Surg.
74: 458-463
[Abstract][Full Text]
Longenecker, J. C., Coresh, J., Powe, N. R., Levey, A. S., Fink, N. E., Martin, A., Klag, M. J.
(2002). Traditional Cardiovascular Disease Risk Factors in Dialysis Patients Compared with the General Population: The CHOICE Study. J. Am. Soc. Nephrol.
13: 1918-1927
[Abstract][Full Text]
Januzzi, J. L. Jr, Snapinn, S. M., DiBattiste, P. M., Jang, I.-K., Theroux, P.
(2002). Benefits and Safety of Tirofiban Among Acute Coronary Syndrome Patients With Mild to Moderate Renal Insufficiency: Results From the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) Trial. Circulation
105: 2361-2366
[Abstract][Full Text]
Szczech, L.A., Best, P.J., Crowley, E., Brooks, M.M., Berger, P.B., Bittner, V., Gersh, B.J., Jones, R., Califf, R.M., Ting, H.H., Whitlow, P.J., Detre, K.M., Holmes, D., for the Bypass Angioplasty Revascularization Inves,
(2002). Outcomes of Patients With Chronic Renal Insufficiency in the Bypass Angioplasty Revascularization Investigation. Circulation
105: 2253-2258
[Abstract][Full Text]
Herzog, C. A.
(2002). Dismal long-term survival of dialysis patients after acute myocardial infarction: can we alter the outcome?. Nephrol Dial Transplant
17: 7-10
[Full Text]
Jardine, A. G, McLaughlin, K.
(2001). GENERAL CARDIOLOGY: Cardiovascular complications of renal disease. Heart
86: 459-466
[Full Text]
Shlipak, M. G., Simon, J. A., Grady, D., Lin, F., Wenger, N. K., Furberg, C. D., for the Heart and Estrogen/progestin Replacement S,
(2001). Renal insufficiency and cardiovascular events in postmenopausal women with coronary heart disease. J Am Coll Cardiol
38: 705-711
[Abstract][Full Text]
Gradaus, F., Ivens, K., Peters, A. J., Heering, P., Schoebel, F.-C., Grabensee, B., Strauer, B.-E.
(2001). Angiographic progression of coronary artery disease in patients with end-stage renal disease. Nephrol Dial Transplant
16: 1198-1202
[Abstract][Full Text]
Le Feuvre, C, Dambrin, G, Helft, G, Beygui, F, Touam, M, Grünfeld, J P, Vacheron, A, Metzger, J P
(2001). Clinical outcome following coronary angioplasty in dialysis patients: a case-control study in the era of coronary stenting. Heart
85: 556-560
[Abstract][Full Text]
Ooi, D. S., Zimmerman, D., Graham, J., Wells, G. A.
(2001). Cardiac Troponin T Predicts Long-Term Outcomes in Hemodialysis Patients. Clin. Chem.
47: 412-417
[Abstract][Full Text]
Previous
