Question: Do patients with chronic kidney disease do worse after a heart attack compared with patients who do not have chronic kidney disease?
Answer: Over the last five years or so, we've learned that chronic kidney disease is a very important risk factor first to develop atherosclerosis -- that is, blockages in the arteries of the heart, and in other vascular systems or other blood vessels of the body -- and two, when patients have chronic kidney disease, they are more likely to have heart attacks, and, yes, after a heart attack, they are more likely to die and have other complications.
So chronic kidney disease has actually emerged as one of the most powerful risk factors for patients doing poorly in terms of developing coronary artery disease, having heart attacks, and then having a poor prognosis after the heart attack.
Patients with chronic kidney disease must be managed very, very carefully. They require, of course, if severe, dialysis.
Other risk factors are more common in patients with chronic kidney disease, such as diabetes and high blood pressure, and it can be more difficult to control diabetes and high blood pressure in patients with chronic kidney disease.
That can contribute to the worse outcome in patients who do develop heart disease, so these are very special patients we've learned, who require a very close relationship and frequent visits with their care-giving team.