Prognostic value of silent myocardial infarction in patients with chronic kidney disease being evaluated for kidney transplantation

• Published in: International journal of cardiology 2017-12, Vol.249, p.377-382
• Main Authors: Farag, Ayman A., AlJaroudi, Wael, Neill, John, Doppalapudi, Harish, Kumar, Vineeta, Rizk, Dana, Iskandrian, Ami E., Hage, Fadi G.
• Format: Article
• Language: English
• Subjects: Adult; Clinical; Cohort Studies; Electrocardiography - trends; End-stage renal disease; Female; Follow-Up Studies; Humans; Kidney Transplantation - mortality; Kidney Transplantation - trends; Male; Middle Aged; Mortality - trends; Myocardial infarction; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Prognosis; Prospective Studies; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - mortality; Renal Insufficiency, Chronic - physiopathology; Silent; Unrecognized
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2017.09.175

Patients with advanced chronic kidney disease (CKD) have increased risk of myocardial infarction (MI). Silent MIs (SMIs) are common in CKD patients and carry increased mortality risk. The prevalence and prognostic value of SMI in advanced CKD has not been evaluated. We identified consecutive patients with advanced CKD who were evaluated for renal transplantation at the University of Alabama at Birmingham between June 2004 and January 2006. Clinical MI (CMI) was determined by review of medical records. SMI was defined as ECG evidence of MI without clinical history of MI. The primary end-point was a composite of death, MI, or coronary revascularization censored at time of renal transplantation. The cohort included 1007 patients with advanced CKD aged 48±12years (58% men, 43% diabetes, 75% on dialysis). The prevalence of SMI and CMI was 10.7% and 6.7%, respectively. The only independent predictor of SMI was older age (odds ratio for age ≥50yrs. 2.32, p