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Abstract: TH-PO235

Population Trends in the Incidence, Treatment, and Outcomes of Myocardial Infarction and Stroke in Patients with Kidney Failure: A National Data-Linkage Study

Session Information

Category: Hypertension and CVD

  • 1602 Hypertension and CVD: Clinical


  • Gallacher, Peter James, The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, Edinburgh, United Kingdom
  • Dhaun, Neeraj, The University of Edinburgh Centre for Cardiovascular Science, Edinburgh, Edinburgh, United Kingdom

Temporal trends of myocardial infarction and stroke are declining in the general population, but have not been evaluated in patients with kidney failure (ie. on dialysis/with a kidney transplant). We describe national trends in the incidence, treatment and outcomes of myocardial infarction and stroke in patients with kidney failure over a 20-year period, stratified by age and sex.


In this retrospective national data-linkage study, all patients with kidney failure in Scotland (UK) experiencing an incident myocardial infarction or stroke between 01/01/1996 and 12/31/2016 were linked to national hospitalization, prescribing and death records. The primary outcome was 1-year cardiovascular death. Generalized additive models were constructed to estimate age-standardized, sex-stratified incidence rates and trends in mortality.


Amongst 16,050 patients with kidney failure (52±15 years;41.5% women), there were 1,992 (66±12 years;34.8% women) and 996 (65±13 years;45.1% women) incident myocardial infarctions and strokes between 01/01/1996 and 12/31/2016. The age-standardized incidence of myocardial infarction per 100,000 decreased in men (from 4,376 [95% confidence interval [CI] 3,998-4,785] to 1,835 [95%CI 1,692-1,988]) and women (from 3,268 [95%CI 2,982-3,593] to 1,369 [95%CI 1,257-1,491]). The age-standardized incidence of stroke per 100,000 also decreased in men (from 1,978 [95%CI 1,795-2,175] to 799 [95%CI 729-875]) and women (from 2,234 [95%CI 2,031-2,468] to 903 [95%CI 824-990]).

Compared to the general population, the incidence of myocardial infarction was 4-8-fold higher in patients with kidney failure, whilst for stroke it was 2-4-fold higher. The use of evidence-based cardioprotective treatment increased and the predicted probability of 1-year cardiovascular death following myocardial infarction for a 66-year-old patient with kidney failure (mean age of cohort) fell in men (76.6% to 38.6%) and women (76.8% to 38.8%), and also decreased in both sexes following stroke (men: 63.5% to 41.4%; women: 67.6% to 45.8%).


The incidence of myocardial infarction and stroke has halved in patients with kidney failure over the past 20 years but remains significantly higher than in the general population. Despite improvements in treatment, the prognosis of these high-risk patients remains poor.