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Survival Benefit of Kidney Transplantation in Patients With End-Stage Kidney Disease and Prior Acute Myocardial Infarction

Authors
 Deok-Gie Kim  ;  Dong-Hyuk Cho  ;  Kihyun Kim  ;  Sung Hwa Kim  ;  Juhan Lee  ;  Kyu Ha Huh  ;  Myoung Soo Kim  ;  Dae Ryong Kang  ;  Jae Won Yang  ;  Byoung Geun Han  ;  Jun Young Lee 
Citation
 TRANSPLANT INTERNATIONAL, Vol.36 : 11491, 2023-08 
Journal Title
TRANSPLANT INTERNATIONAL
ISSN
 0934-0874 
Issue Date
2023-08
MeSH
Aged ; Heart Failure* ; Humans ; Kidney Failure, Chronic* / complications ; Kidney Failure, Chronic* / surgery ; Kidney Transplantation* ; Myocardial Infarction* / surgery ; Renal Dialysis
Keywords
acute myocardial infarction ; end stage kidney disease (ESKD) ; kidney transplantation (KT) ; major adverse cardiovascular events (MACE) ; mortalit
Abstract
Patients with end stage kidney disease (ESKD) and a previous acute myocardial infarction (AMI) have less access to KT. Data on ESKD patients with an AMI history who underwent first KT or dialysis between January 2007 and December 2018 were extracted from the Korean National Health Insurance Service. Patients who underwent KT (n = 423) were chronologically matched in a 1:3 ratio with those maintained on dialysis (n = 1,269) at the corresponding dates, based on time-conditional propensity scores. The 1, 5, and 10 years cumulative incidences for all-cause mortality were 12.6%, 39.1%, and 60.1% in the dialysis group and 3.1%, 7.2%, and 14.5% in the KT group. Adjusted hazard ratios (HRs) of KT versus dialysis were 0.17 (95% confidence interval [CI], 0.12-0.24; p < 0.001) for mortality and 0.38 (95% CI, 0.23-0.51; p < 0.001) for major adverse cardiovascular events (MACE). Of the MACE components, KT was most protective against cardiovascular death (HR, 0.23; 95% CI, 0.12-0.42; p < 0.001). Protective effects of KT for all-cause mortality and MACE were consistent across various subgroups, including patients at higher risk (e.g., age >65 years, recent AMI [<6 months], congestive heart failure). KT is associated with lower all-cause mortality and MACE than maintenance dialysis patients with a prior AMI.
Files in This Item:
T202305064.pdf Download
DOI
10.3389/ti.2023.11491
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Deok Gie(김덕기)
Kim, Myoung Soo(김명수) ORCID logo https://orcid.org/0000-0002-8975-8381
Lee, Ju Han(이주한)
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196305
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