{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T03:47:17Z","timestamp":1781668037667,"version":"3.54.5"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2018,12,18]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We sought to determine temporal trends in use of evidence\u2010based therapies and clinical outcomes among myocardial infarction (\n              <jats:styled-content style=\"fixed-case\">MI)<\/jats:styled-content>\n              patients with chronic kidney disease (\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              ).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              <jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>\n              patients from the NCDR (National Cardiovascular Data Registry) Chest Pain\u2013\n              <jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>\n              Registry between January 2007 and December 2015 were categorized into 3 groups by degree of\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              (end\u2010stage renal disease on dialysis,\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              [glomerular filtration rate &lt;60\u00a0mL\/min per 1.73\u00a0m\n              <jats:sup>2<\/jats:sup>\n              ] not requiring dialysis, and no\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              [glomerular filtration rate \u226560\u00a0mL\/min per 1.73\u00a0m\n              <jats:sup>2<\/jats:sup>\n              ]). Logistic regression modeling was used to determine the association between calendar years (2014\u20132015 versus 2007\u20132008) and each outcome by degree of\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              . Among 325\u00a0396 patients with ST\u2010segment\u2013elevation MI, 1.0% had end\u2010stage renal disease requiring dialysis, and 26.1% had\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              not requiring dialysis. Use of primary percutaneous coronary intervention increased over time regardless of the presence or degree of\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              (\n              <jats:italic>P=<\/jats:italic>\n              0.40 for interaction). In\u2010hospital mortality was temporally higher among patients with preserved renal function (odds ratio: 1.25; 95% confidence interval, 1.13\u20131.39;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) but not among patients with\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              =0.035 for interaction). Among 506\u00a0876 non\u2013ST\u2010segment\u2013elevation MI patients, 3.4% had end\u2010stage renal disease requiring dialysis, and 34.4% had\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              not requiring dialysis. P2Y\n              <jats:sub>12<\/jats:sub>\n              inhibitor use within 24\u00a0hours increased over time only among dialysis patients (\n              <jats:italic>P<\/jats:italic>\n              for interaction &lt;0.001). Use of coronary angiography and percutaneous coronary intervention also increased, with the greatest increase among dialysis patients (\n              <jats:italic>P<\/jats:italic>\n              for interaction &lt;0.001 and &lt;0.001, respectively). In\u2010hospital mortality was lower, regardless of the presence or degree of\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              (\n              <jats:italic>P<\/jats:italic>\n              =0.64 for interaction).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Uptake of evidence\u2010based medical and invasive therapies has increased over the past decade among\n              <jats:styled-content style=\"fixed-case\">MI<\/jats:styled-content>\n              patients with\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              , particularly dialysis patients, with improvement of in\u2010hospital mortality observed among patients with non\u2013ST\u2010segment\u2013elevation MI, but not ST\u2010segment\u2013elevation MI, and\n              <jats:styled-content style=\"fixed-case\">CKD<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.118.010394","type":"journal-article","created":{"date-parts":[[2018,12,5]],"date-time":"2018-12-05T10:01:01Z","timestamp":1544004061000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":32,"title":["Temporal Trends in Utilization of Cardiac Therapies and Outcomes for\u00a0Myocardial Infarction by Degree of Chronic Kidney Disease: A\u00a0Report From the NCDR Chest Pain\u2013MI Registry"],"prefix":"10.1161","volume":"7","author":[{"given":"Akshay","family":"Bagai","sequence":"first","affiliation":[{"name":"Terrence Donnelly Heart Center St. Michael's Hospital University of Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Di","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Cardiology Duke University Medical Center 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