Abstract: FR-PO348
Trends in the Burden of Ischemic Heart Disease among Patients with CKD in Alberta
Session Information
- Hypertension, CVD, and the Kidneys: Epidemiology
October 25, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Hypertension and CVD
- 1602 Hypertension and CVD: Clinical
Authors
- Cooper, Matthew, University of Toronto, Toronto, Ontario, Canada
- Ye, Feng, University of Alberta, Edmonton, Alberta, Canada
- Ghimire, Anukul, University of Calgary, Calgary, Alberta, Canada
- Oudit, Gavin, University of Alberta, Edmonton, Alberta, Canada
- Bello, Aminu K., University of Alberta, Edmonton, Alberta, Canada
Background
Ischemic heart disease (IHD) is a leading cause of mortality in patients with chronic kidney disease (CKD). The last decades have witnessed significant improvements in both IHD and CKD care. Information on the burden of IHD in the Canadian CKD population is limited.
Methods
Using the Alberta Kidney Disease Network database, we created a cohort with CKD (aged 18 years and above) who received a diagnosis of IHD between 2003 and 2019. CKD was defined based on standard methods. Case definitions for IHD, STEMI, and NSTEMI were determined using ICD-10 codes and obtained from hospital discharge records, physician billing claims, and ambulatory care classification system (ACCS) files. The date of diagnosis of IHD was the date of inpatient hospital separation or the physician visit, whichever came first. Univariate least squares regression analysis and the negative binomial model were used to evaluate the trend in the adjusted prevalence and incident rates for the conditions of interest. The rates were standardized by age group and sex based on the 2011 Canadian population. STATA v18 was used in the analysis and p < 0.05 as the threshold for statistical significance.
Results
The age and sex standardized prevalence of IHD increased across all stages of kidney function. Compared to patients with an eGFR ≥ 60 ml/min, the rate of change in the prevalence of IHD was higher in patients with an eGFR 45-59 ml/min, with an annual rate of change of 0.86 (95% CI: 0.66 - 1.05; test for interaction p <0.001). The incidence of STEMI decreased across all eGFRs from 2003 to 2019 except for patients with an eGFR 45-59 ml/min/1.73m2 (incidence risk ratio (IRR) of 0.93 (CI 95% 0.87, 1.00). The incidence of NSTEMI decreased across all eGFRs from 2003 to 2019 except for patients with an eGFR <15 ml/min/1.73m2 (IRR: 0.96; CI 95%: 0.91, 1.02).
Conclusion
Between 2003 and 2019, the prevalence of IHD increased across all stages of CKD, and there was a concomitant decreasing trend in the incidence of the acute forms of IHD (STEMI and NSTEMI). This may reflect increasing longevity of patients with IHD and CKD in Alberta between 2003 and 2019, due to improvements in their care. Future studies should evaluate the quality of care received by patients with IHD and CKD and relationships to adverse clinical outcomes including hospitalizations, recurrent events and mortality.
Funding
- Private Foundation Support