TY - JOUR
T1 - Diagnosis and therapy of coronary artery disease in renal failure, end-stage renal disease, and renal transplant populations
AU - Logar, Christine M.
AU - Herzog, Charles A
AU - Beddhu, Srinivasan
PY - 2003/4/1
Y1 - 2003/4/1
N2 - Even though cardiovascular disease is the leading cause of death in patients with CRF and end-stage renal disease (ESRD), ill-conceived notions have led to therapeutic nihilism as the predominant strategy in the management of cardiovascular disease in these populations. The recent data clearly support the application of proven interventions in the general population, such as angiotensin-converting enzyme inhibitors and statins to patients with CRF and ESRD. The advances in coronary stents and intracoronary irradiation have decreased the restenosis rates in renal failure patients. Coronary artery bypass with internal mammary graft might be the procedure of choice for coronary revascularization in these patients. The role of screening for asymptomatic coronary disease is established as a pretransplant procedure, but it is unclear whether this will be applicable to all patients with ESRD. Future studies need to focus on unraveling the mechanisms by which uremia leads to increased cardiovascular events to design optimal therapies targeted toward these mechanisms and improve cardiovascular outcomes.
AB - Even though cardiovascular disease is the leading cause of death in patients with CRF and end-stage renal disease (ESRD), ill-conceived notions have led to therapeutic nihilism as the predominant strategy in the management of cardiovascular disease in these populations. The recent data clearly support the application of proven interventions in the general population, such as angiotensin-converting enzyme inhibitors and statins to patients with CRF and ESRD. The advances in coronary stents and intracoronary irradiation have decreased the restenosis rates in renal failure patients. Coronary artery bypass with internal mammary graft might be the procedure of choice for coronary revascularization in these patients. The role of screening for asymptomatic coronary disease is established as a pretransplant procedure, but it is unclear whether this will be applicable to all patients with ESRD. Future studies need to focus on unraveling the mechanisms by which uremia leads to increased cardiovascular events to design optimal therapies targeted toward these mechanisms and improve cardiovascular outcomes.
KW - Coronary artery disease
KW - Coronary revascularization
KW - End-stage renal disease (ESRD)
KW - Renal transplantation
UR - http://www.scopus.com/inward/record.url?scp=0345700764&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0345700764&partnerID=8YFLogxK
U2 - 10.1097/00000441-200304000-00008
DO - 10.1097/00000441-200304000-00008
M3 - Article
C2 - 12695727
AN - SCOPUS:0345700764
SN - 0002-9629
VL - 325
SP - 214
EP - 227
JO - American Journal of the Medical Sciences
JF - American Journal of the Medical Sciences
IS - 4
ER -