Renal Insufficiency is Related to Painless Myocardial Infarction

Komukai, Kimiaki; Ogawa, Takayuki; Yagi, Hideki; Date, Taro; Suzuki, Kiyofumi; Sakamoto, Hiroshi; Miyazaki, Hidekazu; Takatsuka, Hisashi; Shibayama, Kentaro; Ogawa, Kazuo; Kanzaki, Yasuko; Kosuga, Tsuneharu; Kikuchi, Makoto; Hongo, Kazuhiro; Yoshida, Shigeo; Taniguchi, Ikuo; Mochizuki, Seibu

doi:10.1253/circj.71.1366

Cited by 14 publications

(9 citation statements)

References 19 publications

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“…The cause of this is thought to be the impairment of sensory and autonomic nerve functions seen in patients with renal failure. It was demonstrated in a study made by Komukai et al that as the renal function disorders increased, the prevalence of painless MI also increased (Komukai et al, 2007). In another study conducted by Pitsavos C et al, it was shown that MI patients with renal failure admitted to the hospital late and the possible reason for such late admission was thought to be the less occurence of alerting symptoms such as chest pain in this patient group (Pitsavos et al, 2007).…”

Section: Myocardiac Infarctionmentioning

confidence: 69%

Acute Complications of Hemodialysis

Özkan¹,

Ulusoy²

2011

Technical Problems in Patients on Hemodialysis

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Section: Myocardiac Infarctionmentioning

confidence: 69%

Acute Complications of Hemodialysis

Özkan¹,

Ulusoy²

2011

Technical Problems in Patients on Hemodialysis

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“…Patients with chronic renal failure appear particularly disposed to silent ischemia. 11 In patients following myocardial infarction, 80-100% manifest silent ischemic episodes. 12 In patients with unstable angina, upwards of 90% have evidence of silent ischemia, 13 whereas in patients with sudden death, almost all are observed to have periods of silent myocardial ischemia.…”

Section: Definition and Prevalencementioning

confidence: 99%

Silent Myocardial Ischemia

Gutterman

2009

Circ J

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Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed. (Circ J 2009; 73: 785 -797)

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“…Dyslipidemia was defined as serum total cholesterol concentration ≥220 mg/dl, serum high-density lipoprotein-cholesterol concentration ≤40 mg/dl, serum triglyceride concentration ≥150 mg/dl, or previous treatment. 7 Anemia was defined as a serum hemoglobin concentration on admission <11 g/dl. 8,9 Systolic dysfunction was defined as an ejection fraction on admission, estimated with echocardiography, of less than 50%.…”

mentioning

confidence: 99%

Decreased Renal Function as an Independent Predictor of Re-Hospitalization for Congestive Heart Failure

Komukai

Ogawa

Yagi

et al. 2008

Circ J

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atients with congestive heart failure (CHF) are frequently re-hospitalized, worsening their quality of life, and re-hospitalization for CHF is also associated with increased mortality rates. 1,2 Therefore, re-hospitalization for CHF should be avoided. Renal insufficiency increases the risk of CHF, [3][4][5] but most studies that have investigated the role of renal function in CHF have included only subjects with no known CHF or mild-to-moderate CHF and excluded patients with severe renal dysfunction. Patients hospitalized for CHF have more severe disease and impaired renal function, but little is known about the relation between renal dysfunction and re-hospitalization because of CHF. Thus, the aim of the present study was to investigate whether renal dysfunction is associated with rehospitalization for CHF after successful discharge. MethodsThe study protocol was approved by the Ethics Committee of The Jikei University School of ).Patients with CHF who had been admitted from January 2003 through December 2004 and followed up after discharge at the outpatient clinic were reviewed. CHF was diagnosed by 2 or more cardiologists on the basis of the Framingham criteria. Patients were excluded if they had CHF complicated by acute myocardial infarction, were undergoing or starting dialysis during the follow-up period, or had undergone cardiac surgery during the follow-up period. With these selection criteria, 109 patients were enrolled. The duration of follow-up was 6-1,466 days (mean, 496 days; median, 348 days). The estimated glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation 6 coefficient modified for Japanese patients: estimated GFR = 0.741×175× Cr -1.154 × age -0.203 (ml · min -1 · 1.73 m -2 ). For women, the estimated GFR was multiplied by a correction factor of 0.742.The 109 patients were divided into 2 groups: decreased renal function (estimated GFR on admission <45 ml·min -1 · 1.73 m -2 ; 42 patients) and preserved renal function (estimated GFR on admission ≥45 ml·min -1 ·1.73 m -2 ; 67 patients). The 2 groups were compared on the basis of age, sex, New York Heart Association (NYHA) class on admission, prescribed anti-CHF drugs at discharge, and the rates of coronary artery disease, valvular heart disease, cardiomyopathy, atrial fibrillation, hypertension, diabetes mellitus (DM), dyslipidemia, anemia, systolic dysfunction, previous hospitalization for CHF, and worsening renal function during hospitalization. Cardiomyopathy was defined according to heart catheterization or previous diagnosis. Hypertension was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg, or previous history. DM was defined as fasting plasma glucose concentration ≥126 mg/dl, Background Patients with congestive heart failure (CHF) are often re-hospitalized, worsening both their quality of life and prognosis. Although renal dysfunction reportedly increases the risk of CHF, the association between renal dysfunction and re-hospitalization for CHF remains unclear...

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Renal Insufficiency is Related to Painless Myocardial Infarction

Cited by 14 publications

References 19 publications

Acute Complications of Hemodialysis

Acute Complications of Hemodialysis

Silent Myocardial Ischemia

Decreased Renal Function as an Independent Predictor of Re-Hospitalization for Congestive Heart Failure

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