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Wright RS, Reeder GS, Herzog CA, Albright RC, Williams BA, Dvorak DL, Miller WL, Murphy JG, Kopecky SL, Jaffe AS: Acute myocardial infarction and renal dysfunction: A high-risk combination. Ann Intern Med (2002) 137(7):563-570. • A retrospective cohort study of 3106 patients with acute MI and renal insufficiency is described. Patients with renal failure were at increased risk for death after acute MI and received less aggressive treatment than patients with normal renal function.
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Gibson CM, Pinto DS, Murphy SA, Morrow DA, Hobbach HP, Wiviott SD, Giugliano RP, Cannon CP, Antman EM, Braunwald E: Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality. J Am Coll Cardiol (2003) 42(9):1535- 1543. • Data drawn from the Thrombolysis In MI (TIMI)-10, TIMI-14 and Intravenous nPA for the Treatment of Infarcting Myocardium Early (InTIME-II) clinical trials are presented here. In the setting of ST-elevation MI, elevated impaired creatinine clearance on presentation was associated with increased mortality, independent of other conventional risk factors.
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Gibson CM, Pinto DS, Murphy SA, Morrow DA, Hobbach HP, Wiviott SD, Giugliano RP, Cannon CP, Antman EM, Braunwald E: Association of creatinine and creatinine clearance on presentation in acute myocardial infarction with subsequent mortality. J Am Coll Cardiol (2003) 42(9):1535- 1543. • Data drawn from the Thrombolysis In MI (TIMI)-10, TIMI-14 and Intravenous nPA for the Treatment of Infarcting Myocardium Early (InTIME-II) clinical trials are presented here. In the setting of ST-elevation MI, elevated impaired creatinine clearance on presentation was associated with increased mortality, independent of other conventional risk factors.
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Sharma R, Pellerin D, Gaze DC, Gregson H, Streather CP, Collinson PO, Brecker SJ: Dobutamine stress echocardiography and the resting but not exercise electrocardiograph predict severe coronary artery disease in renal transplant candidates. Nephrol Dial Transplant (2005) 20(10):2207-2214. • A prospective observational study of 125 patients with ESRD is described. All patients underwent coronary angiography, DSE and exercise ECG testing. In a multivariate model including traditional risk factors and cTnT, DSE and an abnormal baseline ECG were the only independent predictors of significant CAD. Cardiac symptoms and exercise ECG did not predict coronary disease in these patients.
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Apple FS, Murakami MM, Pearce LA, Herzog CA: Multi-biomarker risk stratification of N-terminal pro-B-type natriuretic peptide, highsensitivity C-reactive protein, and cardiac troponin T and I in endstage renal disease for all-cause death. Clin Chem (2004) 50(12):2279-2285. •• This study determined the prognostic value of multiple biomarkers for allcause death over two years in 399 ESRD patients. Increased plasma highsensitivity C-reactive protein, cTnT and cTnI above the cutoffs for a reference (eg, normal) population were all independently predictive of subsequent death in ESRD patients. Tertile analysis for NT-proBNP also demonstrated prognostic value.
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Patel AD, Abo-Auda WS, Davis JM, Zoghbi GJ, Deierhoi MH, Heo J, Iskandrian AE: Prognostic value of myocardial perfusion imaging in predicting outcome after renal transplantation. Am J Cardiol (2003) 92(2):146-151. • This study examined the prognostic significance of MPI in 600 patients undergoing renal transplantation. Pre-operative stress perfusion imaging performed on high-risk patients (most of whom had diabetes) showed that significantly less cardiac events occurred in those with normal images than those with abnormal images.
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Dierkes J, Domrose U, Westphal S, Ambrosch A, Bosselmann HP, Neumann KH, Luley C: Cardiac troponin T predicts mortality in patients with end-stage renal disease. Circulation (2000) 102(16):1964-1969. • This report describes 102 hemodialysis patients that were prospectively studied over a two-year period. Total homocysteine and cTnT were important predictors of mortality, whereas other laboratory variables and baseline disease status had less prognostic value.
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Sharma R, Gaze DC, Pellerin D, Metha R, Gregson H, Streather CP, Collinson PO, Brecker SJ: Cardiac structural and functional abnormalities in end stage renal disease patients with elevated cardiac troponin T. Heart (2006) 92(6):804-809. • A prospective observational study of 126 renal transplant candidates. All patients underwent coronary angiography and ESRD patients with elevated cTnT levels were shown to have increased mortality. Elevated levels were strongly associated with diabetes, LV dilatation, impaired LV systolic and diastolic function, but not severe CAD.
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Sharma R, Gaze D, Pellerin D, Gregson H, Collinson P, Streather CP, Mehta RH, Brecker SJ: Elevated plasma N-terminal pro-B-type natriuretic peptide levels predict mortality and cardiac disease in end stage renal disease. Heart (2006): 92(10):1518-1519.
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Sharma R, Gaze DC, Pellerin D, Mehta RL, Gregson H, Streather CP, Collinson PO, Brecker SJ: Ischemia-modified albumin predicts mortality in ESRD. Am J Kidney Dis (2006) 47(3):493-502. • A prospective observational study of 118 renal transplant candidates that identified IMA as a predictor of mortality in ESRD. Patients with elevated levels had larger LV size, decreased systolic function and greater estimated LV filling pressures.
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Sharma R, Gaze DC, Pellerin D, Mehta RL, Gregson H, Streather CP, Collinson PO, Brecker SJ: Ischemia-modified albumin predicts mortality in ESRD. Am J Kidney Dis (2006) 47(3):493-502. • A prospective observational study of 118 renal transplant candidates that identified IMA as a predictor of mortality in ESRD. Patients with elevated levels had larger LV size, decreased systolic function and greater estimated LV filling pressures.
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23
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Roy D, Quiles J, Aldama G, Sinha M, Avanzas P, Arroyo-Espliguero R, Gaze D, Collinson P, Carlos Kaski J: Ischemia modified albumin for the assessment of patients presenting to the emergency department with acute chest pain but normal or non-diagnostic 12-lead electrocardiograms and negative cardiac troponin T. Int J Cardiol (2004) 97(2):297-301. • This prospective study investigated 131 patients presenting to a hospital emergency department with symptoms suggestive of ACS, but with normal or non-diagnostic ECGs. After multivariate analysis, IMA levels > 85 U/ml, age, and prior MI were found to be independent predictors of ACS.
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Roy D, Quiles J, Aldama G, Sinha M, Avanzas P, Arroyo-Espliguero R, Gaze D, Collinson P, Carlos Kaski J: Ischemia modified albumin for the assessment of patients presenting to the emergency department with acute chest pain but normal or non-diagnostic 12-lead electrocardiograms and negative cardiac troponin T. Int J Cardiol (2004) 97(2):297-301. • This prospective study investigated 131 patients presenting to a hospital emergency department with symptoms suggestive of ACS, but with normal or non-diagnostic ECGs. After multivariate analysis, IMA levels > 85 U/ml, age, and prior MI were found to be independent predictors of ACS.
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