Wolfgang C Winkelmayer1, Raisa Levin, Soko Setoguchi. 1. Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02120, USA. wwinkelmayer@partners.org
Abstract
BACKGROUND AND OBJECTIVES: It is unknown whether adherence to recommended medications after myocardial infarction (MI) differs by kidney function. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a retrospective cohort study of older patients who were discharged after MI in two Eastern states between 1995 and 2004. Patients were categorized as having ESRD, having chronic kidney disease (CKD), and being free from diagnosed CKD. Use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB), beta blockers (BB), and statins was assessed within 30 d after discharge. Good adherence was defined as proportion of days covered >80% during the first year after discharge. RESULTS: Compared with patients with no CKD, patients with CKD had 22% lower adjusted use of ACEI/ARB but similar rates of BB and statin use. Patients with ESRD experienced 43% lower ACEI/ARB and 17% lower statin use. Only 64% (BB), 57% (statins), and 54% (ACEI/ARB) of patients had good 1-yr adherence. Adherence was similar between patients with CKD and with no CKD for all study drugs. Fewer patients with ESRD had good adherence to BB. CONCLUSIONS: With the exception of lower ACEI/ARB use in patients with CKD, we found no differences between patients with CKD and with no CKD in their use of and adherence to these cardiovascular medications after MI. Patients with ESRD experienced lower use of ACEI/ARB and statins and lower adherence to BB regimens. Postulated differences in medication use after MI across levels of kidney function are unlikely to explain the observed differences in long-term outcomes.
BACKGROUND AND OBJECTIVES: It is unknown whether adherence to recommended medications after myocardial infarction (MI) differs by kidney function. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was a retrospective cohort study of older patients who were discharged after MI in two Eastern states between 1995 and 2004. Patients were categorized as having ESRD, having chronic kidney disease (CKD), and being free from diagnosed CKD. Use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers (ACEI/ARB), beta blockers (BB), and statins was assessed within 30 d after discharge. Good adherence was defined as proportion of days covered >80% during the first year after discharge. RESULTS: Compared with patients with no CKD, patients with CKD had 22% lower adjusted use of ACEI/ARB but similar rates of BB and statin use. Patients with ESRD experienced 43% lower ACEI/ARB and 17% lower statin use. Only 64% (BB), 57% (statins), and 54% (ACEI/ARB) of patients had good 1-yr adherence. Adherence was similar between patients with CKD and with no CKD for all study drugs. Fewer patients with ESRD had good adherence to BB. CONCLUSIONS: With the exception of lower ACEI/ARB use in patients with CKD, we found no differences between patients with CKD and with no CKD in their use of and adherence to these cardiovascular medications after MI. Patients with ESRD experienced lower use of ACEI/ARB and statins and lower adherence to BB regimens. Postulated differences in medication use after MI across levels of kidney function are unlikely to explain the observed differences in long-term outcomes.
Authors: Wolfgang C Winkelmayer; Sebastian Schneeweiss; Helen Mogun; Amanda R Patrick; Jerry Avorn; Daniel H Solomon Journal: Am J Kidney Dis Date: 2005-08 Impact factor: 8.860
Authors: Allan J Collins; Robert Foley; Charles Herzog; Blanche Chavers; David Gilbertson; Areef Ishani; Bertram Kasiske; Jiannong Liu; Lih-Wen Mau; Marshall McBean; Anne Murray; Wendy St Peter; Jay Xue; Qiao Fan; Haifeng Guo; Qi Li; Shuling Li; Suying Li; Yi Peng; Yang Qiu; Tricia Roberts; Melissa Skeans; Jon Snyder; Craig Solid; Changchun Wang; Eric Weinhandl; David Zaun; Rui Zhang; Cheryl Arko; Shu-Cheng Chen; Frederick Dalleska; Frank Daniels; Stephan Dunning; James Ebben; Eric Frazier; Christopher Hanzlik; Roger Johnson; Daniel Sheets; Xinyue Wang; Beth Forrest; Edward Constantini; Susan Everson; Paul Eggers; Lawrence Agodoa Journal: Am J Kidney Dis Date: 2008-01 Impact factor: 8.860
Authors: Robert N Foley; Anne M Murray; Shuling Li; Charles A Herzog; A Marshall McBean; Paul W Eggers; Allan J Collins Journal: J Am Soc Nephrol Date: 2004-12-08 Impact factor: 10.121
Authors: Richard H Chapman; Joshua S Benner; Allison A Petrilla; Jonothan C Tierce; S Robert Collins; David S Battleman; J Sanford Schwartz Journal: Arch Intern Med Date: 2005-05-23
Authors: Josef Coresh; Elizabeth Selvin; Lesley A Stevens; Jane Manzi; John W Kusek; Paul Eggers; Frederick Van Lente; Andrew S Levey Journal: JAMA Date: 2007-11-07 Impact factor: 56.272
Authors: Wolfgang C Winkelmayer; David M Charytan; M Alan Brookhart; Raisa Levin; Daniel H Solomon; Jerry Avorn Journal: Clin J Am Soc Nephrol Date: 2006-05-31 Impact factor: 8.237
Authors: Paul Muntner; Suzanne E Judd; Marie Krousel-Wood; William M McClellan; Monika M Safford Journal: Am J Kidney Dis Date: 2010-05-14 Impact factor: 8.860
Authors: Kelvin C W Leung; Neesh Pannu; Zhi Tan; William A Ghali; Merril L Knudtson; Brenda R Hemmelgarn; Marcello Tonelli; Matthew T James Journal: Clin J Am Soc Nephrol Date: 2014-10-15 Impact factor: 8.237
Authors: Tara I Chang; Liyan Gao; Todd M Brown; Monika M Safford; Suzanne E Judd; William M McClellan; Nita A Limdi; Paul Muntner; Wolfgang C Winkelmayer Journal: Clin J Am Soc Nephrol Date: 2012-02-16 Impact factor: 8.237
Authors: Héloise Cardinal; Peter Bogaty; Francois Madore; Luce Boyer; Lawrence Joseph; James M Brophy Journal: Clin J Am Soc Nephrol Date: 2009-10-29 Impact factor: 8.237