Management of Ischemic Heart Disease in Patients with Chronic Kidney Disease

American Journal of Cardiovascular Drugs - Tập 8 - Trang 219-231 - 2012
Arif Mutwali1, Liam G. Glynn2, Donal Reddan1,3
1Department of Medicine, Division of Nephrology, National University of Ireland, Galway, Ireland
2Department of General Practice, National University of Ireland, Galway, Ireland
3Unit 1, Merlin Park University Hospital, Galway, Ireland

Tóm tắt

Patients with chronic kidney disease (CKD) and ischemic heart disease (IHD) have strikingly high mortality rates. In the general population, there has been a reduction in the mortality and morbidity rates for IHD through the implementation of effective risk-factor-reduction programs and better interventions for patients with established IHD. No such trend has been observed in patients with end-stage kidney disease. This review article addresses the following topics: (i) epedemiology, pathogenesis, clinical CKD patients with IHD; (ii) diagnostic modalities for IHD and their limitation in CKD patients; (iii) medical treatment options and revascularization strategies for these high-risk patients; and (iv) optimal cardiovascular risk management. Generally, in CKD patients with IHD an aggressive approach to IHD is warranted, a low threshold for diagnostic testing should be employed, and awaiting a clinical trial targeting these patients they should be considered for all proven strategies to improve outcomes.

Tài liệu tham khảo

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