Abstract:
BACKGROUND:Kidney failure causes anemia and is associated with a very high risk of coronary heart disease (CHD). Mildly to moderately decreased kidney function is far more common and also is associated with an elevated prevalence of anemia and CHD risk. Recent data suggest an even higher risk of CHD when both conditions are present. METHODS:We investigated the association of kidney dysfunction and anemia with CHD events (fatal or nonfatal CHD or coronary revascularization procedures) and CHD and all-cause mortality over 12 years of follow-up in 14971 adults aged 45 to 64 years in the ARIC Study. Glomerular filtration rate (GFR) was estimated from calibrated serum creatinine using the MDRD Study equation (< 30 mL/min per 1.73 m2 excluded, n = 32). Anemia was defined as hemoglobin level < 13.5 g/dL in men (648/6746, 9.6%) and < 12 g/dL in women (1049/8225, 12.8%). RESULTS:The prevalence of anemia was progressively higher at lower estimated GFR < 75 mL/min per 1.73 m2 (both P < .001) for both men and women. A total of 1635 (10.9%) participants had a CHD event, 360 (2.4%) died of CHD, and 1722 (11.5%) died of any cause during follow-up. After adjustment for known risk factors, including diabetes, lipid levels, blood pressure, and use of antihypertensive medication, decreased kidney function was associated with a higher risk of recurrent CHD events and mortality from CHD and all causes. These associations were significantly stronger among participants with anemia. The adjusted relative hazards of all-cause mortality associated with moderately decreased versus normal kidney function (GFR 30-59 vs > or = 90 mL/min per 1.73 m2) were 1.7 (95% CI 1.3-2.2) in the absence of anemia and 3.5 (95% CI 2.4-5.1) in the presence of anemia (P interaction = .001). CONCLUSIONS:The combination of moderately decreased kidney function and anemia is associated with an increased risk of CHD events and mortality, emphasizing the need to identify individuals with these conditions and evaluate interventions to treat anemia and slow the progression of chronic kidney disease.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Astor BC,Coresh J,Heiss G,Pettitt D,Sarnak MJdoi
10.1016/j.ahj.2005.03.055subject
Has Abstractpub_date
2006-02-01 00:00:00pages
492-500issue
2eissn
0002-8703issn
1097-6744pii
S0002-8703(05)00358-3journal_volume
151pub_type
杂志文章abstract::Several autoimmune diseases have been associated with increased frequencies of specific histocompatibility (HLA) antigens, particularly for the D (DR) locus, that may be linked to immune response genes. Rheumatic valvular heart disease (RHD) has been postulated to have autoimmune features, but HLA associations have no...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90311-x
更新日期:1986-11-01 00:00:00
abstract::The occurrence of thrombotic events is central to the course of polycythemia vera. Myocardial, cerebral, peripheral, and pulmonary infarctions are frequent and are consequences of throbmoses in small and medium caliber arteries. Thrombosis in large caliber arteries is a rare event. Thrombosis within the chambers of th...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(80)90667-5
更新日期:1980-10-01 00:00:00
abstract::In order to study the origin of the basal systolic murmurs in mitral stenosis, left and right heart catheterization was performed in 18 patients with mitral stenosis using intracardiac phonocardiography. Our data revealed that the basal systolic murmurs originated in the aorta, the pulmonary artery, and the outflow tr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(78)90163-1
更新日期:1978-10-01 00:00:00
abstract::Metoprolol or placebo was gradually withdrawn during 1 week in 115 patients participating in a 3-year, double-blind, postinfarction study. During the first month after withdrawal mental symptoms and increased cardiac symptoms occurred significantly more frequently in the metoprolol group. Disabling symptoms requiring ...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0002-8703(84)90408-3
更新日期:1984-09-01 00:00:00
abstract:BACKGROUND:Recent work has demonstrated a link between retinopathy, a marker of microvascular disease, and the development of heart failure, a finding particularly relevant in individuals with diabetes. Our objective was to assess the relationship between retinopathy and cardiac structure and function in a cohort of in...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.10.019
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:Cardiac pacing can be challenging after a Fontan operation, and limited data exist regarding pacing in adult Fontan patients. The objectives of our study were to determine risk factors for pacing and occurrence of device-related complications (DRCs) and pacemaker reinterventions. METHODS:We performed a retr...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2017.08.019
更新日期:2017-12-01 00:00:00
abstract::We evaluated the long-term angiographic outcome of balloon angioplasty by comparing original and follow-up target coronary narrowing. Rather than using restenosis to determine outcome, as in most angioplasty studies, we took an unusual approach and analyzed outcome in terms that are commonly used in progression and re...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(97)70153-4
更新日期:1997-05-01 00:00:00
abstract:OBJECTIVE:The aim of this study was to determine in pediatric Duchenne (DMD) and Becker muscular dystrophy (BMD) or other dilated cardiomyopathies (ODCM) whether outcomes differ by diagnosis. BACKGROUND:Children with dilated cardiomyopathy are treated as a single undifferentiated group. METHODS:This cohort study of 1...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2008.01.018
更新日期:2008-06-01 00:00:00
abstract:BACKGROUND:The presence of depression after an acute coronary syndrome (ACS) is associated with worse prognosis and lower adherence to risk-reducing behaviors. We reported earlier that an enhanced depression care intervention reduces depression symptoms and major adverse cardiac events. This study evaluates the impact ...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2012.07.024
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Chronic heart failure is associated with impaired renal function, which may worsen during therapy. The incidence, predictors, and consequences of aggravated renal dysfunction (ARD) in patients undergoing intensive therapy for advanced chronic heart failure are unknown. METHODS:We reviewed the experience of ...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70113-4
更新日期:1999-08-01 00:00:00
abstract:BACKGROUND:Low-molecular weight heparins have different pharmacokinetic and pharmacodynamic characteristics and may vary in efficacy. We compared the efficacy of enoxaparin with that of tinzaparin in the management of non-ST-segment elevation acute coronary syndromes (NSTACS). METHODS:A total of 438 patients with NSTA...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/S0002-8703(03)00179-0
更新日期:2003-08-01 00:00:00
abstract:BACKGROUND:Appropriate thromboprophylaxis for patients with atrial fibrillation or atrial flutter (AF) remains a national challenge. METHODS:We hypothesized that a shared decision-making interaction facilitated by an Atrial Fibrillation Shared Decision Making Tool (AFSDM) would improve patient knowledge about atrial f...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2018.01.003
更新日期:2018-05-01 00:00:00
abstract::The acute effects of diltiazem on coronary reactive hyperemia were studied in 12 patients with flow-limiting coronary stenosis. Reactive hyperemia was elicited by injection of 8 ml contrast medium into the left coronary artery, while coronary sinus blood flow and left ventricular and aortic pressures were continuously...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90353-4
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVE:To determine the effect of exercise training on cardiac autonomic modulation in normal older adults by using analysis of heart rate variability. SUBJECTS:The exercise group consisted of 7 men and 9 women aged 66 +/- 4 years. The comparison group consisted of 7 men and 9 women also aged 66 +/- 4 years. METHO...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(99)70162-6
更新日期:1999-09-01 00:00:00
abstract:BACKGROUND:Patients with left ventricular dysfunction who undergo coronary artery bypass graft (CABG) surgery frequently have late sudden cardiac death. The CABG Patch Trial is a prospective, randomized, multicenter clinical trial that randomized patients at high risk at the completion of CABG surgery to implantation o...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0002-8703(97)80001-4
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND:Ibutilide is indicated for the acute termination of atrial fibrillation and atrial flutter. Recent work concludes that ibutilide activates a late inward sodium current that is blocked by nifedipine. Because calcium channel blockers are commonly used in patients with atrial fibrillation, it is important to ex...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1067/mhj.2002.120156
更新日期:2002-01-01 00:00:00
abstract:BACKGROUND:Myocardial infarction (MI) complicated by cardiogenic shock (CS) is associated with high mortality. Early coronary revascularization improves survival, but the optimal mode of revascularization remains uncertain. We sought to characterize practice patterns and outcomes of coronary artery bypass grafting (CAB...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2020.01.020
更新日期:2020-08-01 00:00:00
abstract::Estimation of baroreflex sensitivity (BRS) is receiving increasing attention in clinical and experimental cardiology. Until recently, in most studies BRS has been assessed on the basis of invasive blood pressure measurement, which limits its use in large-scale studies and in clinical practice. The development of conti...
journal_title:American heart journal
pub_type: 临床试验,杂志文章
doi:10.1016/0002-8703(95)90443-3
更新日期:1995-08-01 00:00:00
abstract:BACKGROUND:The aim of this study was to determine the impact of myocardial perfusion imaging (MPI) on the outcomes of death, myocardial infarction (MI), and late coronary revascularization procedures. METHODS:In patients undergoing exercise-stress MPI (January 1, 2003-March 31, 2007), we determined the impact of summe...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2011.01.019
更新日期:2011-05-01 00:00:00
abstract::Fenoldopam mesylate (SK&F 82526-J) is a novel benzazepine derivative. It has selective agonist activity at post-junctional (DA1) vascular dopaminergic receptors, which normally subserve renal artery vasodilation. Previous studies in normal subjects and in patients with hypertension indicate that fenoldopam increases r...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(88)90620-5
更新日期:1988-08-01 00:00:00
abstract:BACKGROUND:Dobutamine and exercise echocardiography are accepted as tests of comparable efficacy for the diagnosis of coronary artery disease. Although dobutamine has been classified as "exercise simulating," the mechanisms of ischemia with dobutamine and exercise have not been well studied. This study sought to compar...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(98)70183-8
更新日期:1998-07-01 00:00:00
abstract:BACKGROUND:Several non-vitamin K antagonist oral anticoagulant (NOAC) alternatives to warfarin are available for stroke prevention in atrial fibrillation (AF). We aimed to describe the factors associated with selection of NOACs versus warfarin in patients with new onset AF. METHODS:The ORBIT-AF II study is a national,...
journal_title:American heart journal
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.ahj.2017.03.024
更新日期:2017-07-01 00:00:00
abstract::Atrial fibrillation is a common disease of the elderly, conferring considerable morbidity and mortality related to cardiovascular effects and thromboembolic risks. Anticoagulation, antiarrhythmic medications, and rate control are the cornerstone of contemporary management, whereas ablation and evolving surgical techni...
journal_title:American heart journal
pub_type: 杂志文章,评审
doi:10.1016/j.ahj.2014.12.015
更新日期:2015-04-01 00:00:00
abstract:BACKGROUND:Erythropoietin mitigates myocardial damage and improves ventricular performance after experimental ischemic injury. This study assessed safety and efficacy markers relevant to the biological activity of recombinant human erythropoietin (rHuEpo) in patients with acute myocardial infarction (MI). METHODS:We c...
journal_title:American heart journal
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ahj.2009.06.032
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:Prior studies regarding the effect of racial status on post-myocardial infarction (MI) in subjects with diabetes have yielded conflicting results. We evaluated the effect of diabetes status on racial differences in post-MI mortality and morbidity for a 7-year period, from 1990 through 1997. METHODS:All pati...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/j.ahj.2005.02.042
更新日期:2005-11-01 00:00:00
abstract::As Q wave and ST segment elevation in leads V1 to V3 may be due either to right ventricular infarction (RVI) or to anterior left ventricular infarction (ALVI), 72 autopsy patients with acute myocardial infarction who had had conventional 12-lead ECG records were studied to determine the accuracy of these ECG criteria,...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(86)90304-2
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:The 6-minute walk test is a submaximal exercise test that is widely used as an outcomes measure in clinical trials and cardiopulmonary rehabilitation. An initial learning effect with repeated administration is well documented, but it is unknown whether this learning effect persists with time. METHODS:This s...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/S0002-8703(03)00119-4
更新日期:2003-07-01 00:00:00
abstract::The clinical course and coronary arteriographic findings in eight patients with Prinzmetal's variant angina pectoris are reviewed and contrasted to previously reported cases. In six patients with S-T-elevation inferiorly, three had normal coronary arteriograms, one had complete right coronary artery occlusion, one ha...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/0002-8703(75)90501-3
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND:Epidemiologic studies suggest that inhibition of renin-angiotensin system with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers may prevent development of atrial fibrillation (AF). OBJECTIVE:The objective of the study was to assess if there is significant indication for using angio...
journal_title:American heart journal
pub_type: 杂志文章,meta分析
doi:10.1016/j.ahj.2006.01.007
更新日期:2006-08-01 00:00:00
abstract::This case report presents a young adult with asymmetric septal hypertrophy (ASH) and syncope. Infranodal complete heart block was demonstrated as his cause for syncope. Therapy consisted of implantation of a A-V sequential pacemaker. Cardiac output determinations and systolic time intervals demonstrated the beneficial...
journal_title:American heart journal
pub_type: 杂志文章
doi:10.1016/s0002-8703(77)80177-4
更新日期:1977-01-01 00:00:00