Impact of chronic kidney disease on mortality and cardiovascular outcomes after acute coronary syndrome: A nationwide data linkage study (ANZACS-QI 44).

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dc.contributor.author Pilmore, Helen L en
dc.contributor.author Xiong, Fei en
dc.contributor.author Choi, Yeunhyang en
dc.contributor.author Poppe, Katrina en
dc.contributor.author Lee, Mildred en
dc.contributor.author Legget, Malcolm en
dc.contributor.author Kerr, Andrew en
dc.date.accessioned 2020-05-11T05:04:06Z en
dc.date.issued 2020-07 en
dc.identifier.issn 1320-5358 en
dc.identifier.uri http://hdl.handle.net/2292/50614 en
dc.description.abstract AIMS:Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease (CVD). We examined the characteristics, management and outcomes of patients with CKD in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) national registry. METHODS:The cohort comprised New Zealand (NZ) patients with an acute coronary syndrome undergoing coronary angiography between January 2013 and December 2016. Patients were categorized according to their stage of CKD. Outcomes included all-cause and cause-specific mortality and hospitalization with myocardial infarction (MI), stroke and major bleeding. RESULTS:Of the 20 604 patients, 20.3% had normal renal function, with 53.3%, 23.3%, 1.7% and 1.4% having CKD stages 2, 3, 4 and 5 CKD, respectively. Patients with severe CKD were more likely to be Māori or Pacific and live in an area with greater socioeconomic deprivation. Death, recurrent MI or stroke, and major bleeding all increased incrementally with each worsening stage of CKD severity. Compared with those with normal renal function, patients with stage 5 CKD had a much higher all-cause (hazard ratio [HR] 16.41, 95% CI 13.06-20.61), cardiovascular (HR 16.38, 95% CI 12.17-22.04) and non-cardiovascular mortality (HR 13.66 9, 95% CI.56-19.51). In addition, patients with stage 5 CKD were at a higher risk of recurrent MI or stroke (HR 4.73, 95% CI 3.86-5.80) and bleeding (HR 5.84, 95% CI 4.39-7.76). CONCLUSION:CKD was associated with increased mortality and a high incidence of morbidity in patients undergoing coronary angiography in New Zealand. Initiatives to understand and improve outcomes in this group of patients are urgently needed. en
dc.format.medium Print-Electronic en
dc.language eng en
dc.relation.ispartofseries Nephrology (Carlton, Vic.) en
dc.rights Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. en
dc.rights.uri https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm en
dc.title Impact of chronic kidney disease on mortality and cardiovascular outcomes after acute coronary syndrome: A nationwide data linkage study (ANZACS-QI 44). en
dc.type Journal Article en
dc.identifier.doi 10.1111/nep.13703 en
pubs.issue 7 en
pubs.begin-page 535 en
pubs.volume 25 en
dc.rights.holder Copyright: The author en
pubs.end-page 543 en
pubs.publication-status Published en
dc.rights.accessrights http://purl.org/eprint/accessRights/RestrictedAccess en
pubs.subtype Journal Article en
pubs.elements-id 796859 en
pubs.org-id Medical and Health Sciences en
pubs.org-id Population Health en
pubs.org-id Epidemiology & Biostatistics en
pubs.org-id School of Medicine en
pubs.org-id Medicine Department en
dc.identifier.eissn 1440-1797 en
pubs.record-created-at-source-date 2020-02-28 en
pubs.dimensions-id 32105376 en


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