People with kidney disease undergo balloon dilation treatment after myocardial infarction less frequently, and therefore have a poorer prognosis. This according to new clinical research published in the journal Circulation.
One third of all patients treated for myocardial infarction have moderately impaired renal function. Myocardial infarction can be treated by improving the blood flow using either balloon dilation or bypass surgery, but it has always been a moot point whether the treatment should be used on heart patients with kidney disease, since the risks - if any - have not been known.
The new study is based on data from over 23,000 people treated for myocardial infarction between 2003 and 2006. The results show that balloon dilation is just as beneficial to heart patients with moderately impaired renal function as it is to those with healthy kidneys, but that a smaller proportion of heart patients with impaired renal function undergo the treatment. The mortality rate for this group was also higher.
"The prognosis for patients with moderately impaired renal function can probably be greatly improved if they undergo balloon dilation treatment to a greater extent," says Karolina Szummer of the Department of Medicine at Karolinska Institutet in Huddinge, one of the researchers behind the study.
The study was carried out as part of a network-based collaboration between clinical scientists at the Swedish medical university Karolinska Institutet, cardiologists from Karolinska University Hospital, and the Renal Medicine Clinic at Danderyd Hospital, all of them situated in Stockholm County. Danderyd Hospital has prioritised the relationship between renal and cardiac disease as one of its most important research fields for the coming years, and has earmarked resources for research within the network.
"Renal disease is as serious a risk factor for cardiovascular disease as diabetes, and around ten per cent of the population has it," says Stefan Jacobson, adjunct professor at Karolinska Institutet and head of Danderyd Hospitals Renal Medicine Clinic. "However, more research is needed before this large patient group can be offered the best possible care."
Karolina Szummer, Pia Lundman, Stefan H Jacobson, Staffan Schön, Johan Lindbäck, Ulf Stenestrand, Lars Wallentin, and Tomas Jernberg; for SWEDEHEARTInfluence of renal function on the effects of early revascularization in non-ST-elevation myocardial infarction - data from the Swedish Web-system for Enhancement and Development of Evidence-based care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART)
Circulation, online 24 August 2009