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首页> 外文期刊>asian journal of surgery >Cardiovascular Drug Use After Acute Kidney Injury Among Hospitalized Patients With a History of Myocardial Infarction
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Cardiovascular Drug Use After Acute Kidney Injury Among Hospitalized Patients With a History of Myocardial Infarction

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Introduction: Patients who survive acute kidney injury (AKI) may receive fewer cardioprotective drugs. Our objective was to measure the difference in time to dispensing of evidence-based cardiovascular drugs in patients with a history of myocardial infarction (MI) with and without AKI. Methods: This was a population-based cohort study of patients 66 years of age and older with a history of MI who survived a hospitalization complicated with AKI, propensity-score matched to patients without AKI. The primary outcome was time to outpatient dispensing of an angiotensin-converting enzyme inhibitor (ACEi)/angiotensin II receptor blocker (ARB), statin, or b-blocker within 1 year of hospital discharge. Results: We identified 28,871 patients with AKI, of whom 21,452 were matched 1:1 to patients without AKI. In the matched cohort, mean age was 80 years, 40 were female, and 34 had an MI during the index hospitalization. AKI was associated with less frequent dispensing of all 3 cardiovascular drug classes within 1 year of hospital discharge (subdistribution hazard ratio sHR, 0.93; 95 confidence interval CI, 0.91–0.95). This association was most pronounced in patients with stage 2 (sHR, 0.81; 95 CI, 0.75–0.88) and stage 3 (sHR, 0.71; 95 CI, 0.64–0.79) AKI. We observed less frequent dispensing of statins in patients with stage 2 (sHR, 0.87; 95 CI, 0.81–0.92) and stage 3 (sHR, 0.85; 95 CI, 0.78–0.93) AKI and less frequent dispensing of b-blockers in patients with stage 3 AKI (sHR, 0.86; 95 CI, 0.79–0.94). Conclusion: In patients with a history of MI, survivors of AKI were less likely to receive prescriptions for ACEi/ARB, statins, or b-blockers within 1 year of hospital discharge. This association was most pronounced in patients with stages 2 and 3 AKI.

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