ISCHEMIC HEART DISEASE AND END STAGE RENAL DISEASE

心血管死亡是慢性阻塞性肺疾病患者的主要死亡原因 血液透析患者。随着人口的持续增长， 显著的心脏风险，由于越来越多的老年人 接受治疗的终末期肾病(ESRD)和糖尿病患者 肾病，越来越多的患者成为缺血性心脏病患者。 ESRD和ESRD使用美国肾脏数据系统。这个 第一个目标是描述发病率的临床决定因素。 慢性心肌梗死患者的死亡率和死亡率 血液透析。令人惊讶的是，没有发表的研究报告了死亡人数 大量慢性心肌梗死患者的急性心肌梗死发生率 血液透析患者(也没有检查治疗结果)，以及最近 溶栓试验已将这些患者排除在外。出于这个原因， 慢性血液透析患者急性心肌梗死的住院总死亡率 将对患者进行评估，并注意临床检查 结果的决定因素。将对以下项目执行类似的单独分析 接受肾移植的患者。 这项研究的第二个目标是检查临床结果 终末期肾病患者，特别是慢性血液透析患者，有 冠状动脉血运重建手术。以前发布的报告 关注冠状动脉血运重建术的结果 终末期肾病患者接受经皮冠状动脉腔内成形术(PTCA) 或冠状动脉搭桥术(CABG)。该病的发病率和死亡率 冠状动脉血运重建术(PTCA或CABG)与临床 影响结果的因素，将在一大批 使用美国肾脏数据系统的终末期肾病患者 将对慢性透析和肾移植患者进行分析。 分开的。 文献中报告的患者总数为 对这项拟议研究中提出的两个问题的阅读 非常小。对之前发布的数据的解释是 因“单一中心偏向”而变得复杂--小型剧集的租赁可能 不准确地反映终末期肾病人群的真实临床经验 逍遥法外。使用美国肾脏数据系统，更准确 与急性心肌梗死相关的发病率和死亡率在 终末期肾病患者与冠状动脉血运重建的结局 在这一患者群体中的手术应该是可以实现的。

Cardiovascular mortality is the predominant cause of death in chronic hemodialysis patients. With the continuing expansion of a population at significant cardiac risk, due to an increasingly larger number of older patients with treated end stage renal disease (ESRD) and diabetic nephropathy, it becomes increasingly of ischemic heart disease in patients with ESRD.The with ESRD utilizing the United States Renal Data System. The first objective is to characterize the clinical determinants of morbidity and mortality of acute myocardial infarction in patients on chronic hemodialysis. Surprisingly, no published study has reported the mortality rate of acute myocardial infarction (MI) in a large population of chronic hemodialysis patients (nor examined therapeutic outcomes), and recent thrombolytic trials have excluded these patients. For this reason, the overall in-hospital mortality rate of acute MI in chronic hemodialysis patients will be estimated, with attention to examination of clinical determinants of outcome. A similar separate analysis will be performed for patients with renal transplants. The second objective of this study is to examine the clinical outcome of patients with ESRD, particularly patients on chronic hemodialysis, having coronary artery revascularization procedures. Previous published reports have focused on results of coronary revascularization in small groups of ESRD patients having percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass surgery (CABG). The morbidity and mortality of coronary artery revascularization procedures (PTCA or CABG) and clinical factors affecting outcome, will be analyzed in a large population of patients with ESRD using the United States Renal Data System Patients on chronic dialysis and those with renal transplants will be analyzed separately. The total number of patients who have been reported in the literature in reads to the two questions posed in this proposed study has been exceedingly small. The interpretation of previously published data is complicated by "single center bias"- the renting of small series may inaccurately reflect the true clinical experience of the ESRD population at large. Using the United States Renal Data System, a more accurate representation of the morbidity and mortality associated with AMI in patients with ESRD and the outcome of coronary artery revascularization procedures in this patient population should be attainable.