Cardiovascular Drug Use After Acute Kidney Injury Among Hospitalized Patients With a History of Myocardial Infarction

被引：3

作者：

Meraz-Munoz, Alejandro Y. ^{[1
]}

Jeyakumar, Nivethika ^{[2
]}

Luo, Bin ^{[2
]}

Beaubien-Souligny, William ^{[3
]}

Chanchlani, Rahul ^{[2
,4
,5
]}

Clark, Edward G. ^{[6
]}

Harel, Ziv ^{[1
,2
]}

Kitchlu, Abhijat ^{[2
,7
]}

Neyra, Javier A. ^{[8
]}

Zappitelli, Michael ^{[9
]}

Chertow, Glenn M. ^{[10
]}

Garg, Amit X. ^{[2
,11
]}

Wald, Ron ^{[1
,2
]}

Silver, Samuel A. ^{[2
,12
,13
]}

机构：

[1] Univ Toronto, St Michaels Hosp, Div Nephrol, Toronto, ON, Canada

[2] ICES, Toronto, ON, Canada

[3] Ctr Hosp Univ Montreal, Div Nephrol, Montreal, PQ, Canada

[4] McMaster Univ, McMaster Children Hosp, Div Pediat Nephrol, Hamilton, ON, Canada

[5] McMaster Univ, Dept Hlth Res Methods Evidence & Impact, Hamilton, ON, Canada

[6] Univ Ottawa, Dept Med, Div Nephrol, Ottawa, ON, Canada

[7] Univ Hlth Network, Univ Toronto, Div Nephrol, Toronto, ON, Canada

[8] Univ Kentucky, Div Nephrol Bone & Mineral Metab, Lexington, KY USA

[9] Univ Toronto, Hosp Sick Children, Div Pediat Nephrol, Toronto, ON, Canada

[10] Stanford Univ, Div Nephrol, Palo Alto, CA USA

[11] Western Univ, London Hlth Sci Ctr, Div Nephrol, London, ON, Canada

[12] Queens Univ, Kingston Hlth Sci Ctr, Div Nephrol, Kingston, ON, Canada

[13] Queens Univ, Div Nephrol, 76 Stuart St, 3-Burr 21-3-039, Kingston, ON 727, Canada

来源：

KIDNEY INTERNATIONAL REPORTS | 2023年 / 8卷 / 02期

基金：

加拿大健康研究院;

关键词：

ACEi; AKI; ARB; ischemic cardiomyopathy; MI; FOLLOW-UP; AKI; RISK; MEDICATIONS; MULTICENTER; GUIDELINES; MANAGEMENT; ADHERENCE; MORTALITY; BLOCKERS;

D O I：

10.1016/j.ekir.2022.10.027

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Introduction: Patients who survive acute kidney injury (AKI) may receive fewer cardioprotective drugs. Our objective was to measure the difference in time to dispensing of evidence-based cardiovascular drugs in patients with a history of myocardial infarction (MI) with and without AKI.Methods: This was a population-based cohort study of patients 66 years of age and older with a history of MI who survived a hospitalization complicated with AKI, propensity-score matched to patients without AKI. The primary outcome was time to outpatient dispensing of an angiotensin-converting enzyme inhibitor (ACEi)/angiotensin II receptor blocker (ARB), statin, or 0-blocker within 1 year of hospital discharge.Results: We identified 28,871 patients with AKI, of whom 21,452 were matched 1:1 to patients without AKI. In the matched cohort, mean age was 80 years, 40% were female, and 34% had an MI during the index hospitalization. AKI was associated with less frequent dispensing of all 3 cardiovascular drug classes within 1 year of hospital discharge (subdistribution hazard ratio [sHR], 0.93; 95% confidence interval [CI], 0.91-0.95). This association was most pronounced in patients with stage 2 (sHR, 0.81; 95% CI, 0.75-0.88) and stage 3 (sHR, 0.71; 95% CI, 0.64-0.79) AKI. We observed less frequent dispensing of statins in patients with stage 2 (sHR, 0.87; 95% CI, 0.81-0.92) and stage 3 (sHR, 0.85; 95% CI, 0.78-0.93) AKI and less frequent dispensing of 0-blockers in patients with stage 3 AKI (sHR, 0.86; 95% CI, 0.79-0.94).Conclusion: In patients with a history of MI, survivors of AKI were less likely to receive prescriptions for ACEi/ARB, statins, or 0-blockers within 1 year of hospital discharge. This association was most pro-nounced in patients with stages 2 and 3 AKI. 2022 International Society of Nephrology. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

引用

页码：294 / 304

页数：11

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