Symptoms of ASCVD strongly associated with MI risk in CKD patients

Symptoms of atherosclerotic cardiovascular disease were substantially related with a greater risk of future myocardial infarction in patients with Chronic Kidney Disease (CKD), says an article published in the Clinical Journal of the American Society of Nephrology.

Although patient-reported symptoms frequently precede acute presentations of cardiovascular disease, individuals with nondialysis-requiring CKD are less likely to exhibit classic atherosclerotic disease symptoms when they come with an acute myocardial infarction. However, in ambulatory individuals with CKD, the correlations between typical atherosclerotic symptoms and eventual risk of myocardial infarction remain uncertain. As a result, Benjamin Lidgard and colleagues undertook this investigation to see if typical atherosclerotic symptoms are linked to the likelihood of a later myocardial infarction in persons with CKD.

Participants with Chronic Renal Insufficiency were investigated for this study. The Kidney Disease Quality of Life Instrument was used to assess shortness of breath, chest discomfort, and capacity to climb stairs on a yearly basis. Cox regression models were used to examine the relationships between physician-adjudicated incident myocardial infarction and categorical time-updated symptoms.

The findings of this study were as follow;

During a median follow-up duration of 10.4 years, there were 476 incident myocardial infarctions among 3910 patients.

The median interval between the onset of symptoms and the occurrence of a myocardial infarction was 213 days.

Symptoms of chest discomfort and shortness of breath were substantially connected with increased chances of later myocardial infarction as compared to no symptoms, mild symptoms, and moderate or severe symptoms.

Participants who reported mild to severe difficulty ascending stairs (as opposed to no difficulty) had a substantially greater adjusted risk of myocardial infarction.

In conclusion, these findings emphasize the potential value of frequent symptom evaluation for early signs of atherosclerotic disease in ambulatory CKD patients. They may also underscore the requirement for appropriate medical management.

Reference:

Lidgard B, Zelnick LR, O'Brien KD, Bansal N, et al. Patient-reported symptoms and subsequent risk of myocardial infarction in chronic kidney disease. Clin J Am Soc Nephrol. Published online March 17, 2022. doi:10.2215/CJN.12080921