Trends in Mortality Due to Myocardial Infarction, Stroke, and Pulmonary Embolism in Patients Receiving Dialysis

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Ocak , G , Boenink , R , Noordzij , M , Bos , W J W , Vikse , B E , Cases , A , Kerschbaum , J , Helve , J , Nordio , M , Arici , M , Mercadal , L , Wanner , C , Palsson , R , Hommel , K , De Meester , J , Kostopoulou , M , Santamaria , R , Rodrigo , E , Rydell , H , Bell , S , Massy , Z A , Jager , K J & Kramer , A 2022 , ' Trends in Mortality Due to Myocardial Infarction, Stroke, and Pulmonary Embolism in Patients Receiving Dialysis ' , JAMA Network Open , vol. 5 , no. 4 , 227624 . https://doi.org/10.1001/jamanetworkopen.2022.7624

Title: Trends in Mortality Due to Myocardial Infarction, Stroke, and Pulmonary Embolism in Patients Receiving Dialysis
Author: Ocak, Gurbey; Boenink, Rianne; Noordzij, Marlies; Bos, Willem Jan W.; Vikse, Bjorn E.; Cases, Aleix; Kerschbaum, Julia; Helve, Jaakko; Nordio, Maurizio; Arici, Mustafa; Mercadal, Lucile; Wanner, Christoph; Palsson, Runolfur; Hommel, Kristine; De Meester, Johan; Kostopoulou, Myrto; Santamaria, Rafael; Rodrigo, Emilio; Rydell, Helena; Bell, Samira; Massy, Ziad A.; Jager, Kitty J.; Kramer, Anneke
Contributor organization: HUS Abdominal Center
Nefrologian yksikkö
Department of Medicine
University of Helsinki
Date: 2022-04-18
Language: eng
Number of pages: 14
Belongs to series: JAMA Network Open
ISSN: 2574-3805
DOI: https://doi.org/10.1001/jamanetworkopen.2022.7624
URI: http://hdl.handle.net/10138/343460
Abstract: IMPORTANCE During the past decades, improvements in the prevention and management of myocardial infarction, stroke, and pulmonary embolism have led to a decline in cardiovascular mortality in the general population. However, it is unknown whether patients receiving dialysis have also benefited from these improvements. OBJECTIVE To assess the mortality rates for myocardial infarction, stroke, and pulmonary embolism in a large cohort of European patients receiving dialysis compared with the general population. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, adult patients who started dialysis between 1998 and 2015 from 11 European countries providing data to the European Renal Association Registry were and followed up for 3 years. Data were analyzed from September 2020 to February 2022. EXPOSURES Start of dialysis. MAIN OUTCOMES AND MEASURES The age- and sex-standardized mortality rate ratios (SMRs) with 95% CIs were calculated by dividing the mortality rates in patients receiving dialysis by the mortality rates in the general population for 3 equal periods (1998-2003, 2004-2009, and 2010-2015). RESULTS In total, 220 467 patients receiving dialysis were included in the study. Their median (IQR) age was 68.2 (56.5-76.4) years, and 82 068 patients (37.2%) were female. During follow-up, 83 912 patients died, of whom 7662 (9.1%) died because of myocardial infarction, 5030 (6.0%) died because of stroke, and 435 (0.5%) died because of pulmonary embolism. Between the periods 1998 to 2003 and 2010 to 2015, the SMR of myocardial infarction decreased from 8.1 (95% CI, 7.8-8.3) to 6.8 (95% CI, 6.5-7.1), the SMR of stroke decreased from 7.3 (95% CI, 7.0-7.6) to 5.8 (95% CI, 5.5-6.2), and the SMR of pulmonary embolism decreased from 8.7 (95% CI, 7.6-10.1) to 5.5 (95% CI, 4.5-6.6). CONCLUSIONS AND RELEVANCE In this cohort study of patients receiving dialysis, mortality rates for myocardial infarction, stroke, and pulmonary embolism decreased more over time than in the general population.
Subject: PERCUTANEOUS CORONARY INTERVENTION
MAINTENANCE HEMODIALYSIS-PATIENTS
CHRONIC KIDNEY-DISEASE
ERA-EDTA REGISTRY
ATRIAL-FIBRILLATION
NATIONAL TRENDS
UNITED-STATES
CASE-FATALITY
TIME TRENDS
WARFARIN
3121 General medicine, internal medicine and other clinical medicine
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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