The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study.

Hdl Handle:
http://hdl.handle.net/10147/93843
Title:
The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study.
Authors:
Anderson, Jocelyn; Glynn, Liam G; Newell, John; Iglesias, Alberto A; Reddan, Donal; Murphy, Andrew W
Affiliation:
Department of General Practice, NUI Galway, Ireland. j.anderson2@nuigalway.ie
Citation:
The impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study. 2009, 9:51 BMC Cardiovasc Disord
Journal:
BMC cardiovascular disorders
Issue Date:
2009
URI:
http://hdl.handle.net/10147/93843
DOI:
10.1186/1471-2261-9-51
PubMed ID:
19909540
Abstract:
BACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.
Language:
en
MeSH:
Aged; Anemia; Cardiovascular Diseases; Cause of Death; Chi-Square Distribution; Cohort Studies; Comorbidity; Female; Humans; Ireland; Kaplan-Meiers Estimate; Male; Middle Aged; Prevalence; Proportional Hazards Models; Renal Insufficiency, Chronic; Retrospective Studies; Risk Assessment; Risk Factors; Time Factors
ISSN:
1471-2261

Full metadata record

DC FieldValue Language
dc.contributor.authorAnderson, Jocelynen
dc.contributor.authorGlynn, Liam Gen
dc.contributor.authorNewell, Johnen
dc.contributor.authorIglesias, Alberto Aen
dc.contributor.authorReddan, Donalen
dc.contributor.authorMurphy, Andrew Wen
dc.date.accessioned2010-03-08T13:08:49Z-
dc.date.available2010-03-08T13:08:49Z-
dc.date.issued2009-
dc.identifier.citationThe impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study. 2009, 9:51 BMC Cardiovasc Disorden
dc.identifier.issn1471-2261-
dc.identifier.pmid19909540-
dc.identifier.doi10.1186/1471-2261-9-51-
dc.identifier.urihttp://hdl.handle.net/10147/93843-
dc.description.abstractBACKGROUND: The simultaneous occurrence of cardiovascular disease (CVD), kidney disease, and anaemia is associated with increased morbidity and mortality. In the community setting, little data exists about the risk associated with milder levels of anaemia when it is present concurrently with CVD and chronic kidney disease (CKD). The aim of this study was to establish the prevalence of CKD and anaemia in patients with CVD in the community and to examine whether the presence of anaemia was associated with increased morbidity and mortality. METHODS: This study was designed as a retrospective cohort study and involved a random sample of 35 general practices in the West of Ireland. A practice-based sample of 1,609 patients with established cardiovascular disease was generated in 2000/2001 and followed for five years. The primary endpoint was death from any cause. Statistical analysis involved using one-way ANOVA and Chi-squared tests for baseline data and Cox proportional-hazards models for mortality data. RESULTS: Of the study sample of 617 patients with blood results, 33% (n = 203) had CKD while 6% (n = 37) had CKD and anaemia. The estimated risk of death from any cause, when compared to patients with cardiovascular disease only, was almost double (HR = 1.98, 95% CI 0.99 to 3.98) for patients with both CVD and CKD and was over 4 times greater (HR = 4.33, 95% CI 1.76 to 10.68) for patients with CVD, CKD and anaemia. CONCLUSION: In patients with cardiovascular disease in the community, chronic kidney disease and anaemia occur commonly. The presence of chronic kidney disease carries an increased mortality risk which increases in an additive way with the addition of anaemia. These results suggest that early primary care diagnosis and management of this high risk group may be worthwhile.-
dc.language.isoenen
dc.subject.meshAged-
dc.subject.meshAnemia-
dc.subject.meshCardiovascular Diseases-
dc.subject.meshCause of Death-
dc.subject.meshChi-Square Distribution-
dc.subject.meshCohort Studies-
dc.subject.meshComorbidity-
dc.subject.meshFemale-
dc.subject.meshHumans-
dc.subject.meshIreland-
dc.subject.meshKaplan-Meiers Estimate-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshPrevalence-
dc.subject.meshProportional Hazards Models-
dc.subject.meshRenal Insufficiency, Chronic-
dc.subject.meshRetrospective Studies-
dc.subject.meshRisk Assessment-
dc.subject.meshRisk Factors-
dc.subject.meshTime Factors-
dc.titleThe impact of renal insufficiency and anaemia on survival in patients with cardiovascular disease: a cohort study.en
dc.contributor.departmentDepartment of General Practice, NUI Galway, Ireland. j.anderson2@nuigalway.ieen
dc.identifier.journalBMC cardiovascular disordersen

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