Heart Attack Care Lax in Dialysis Patients

Dialysis patients are less likely to get aggressive and potentially lifesaving treatment after a heart attack, according to a new study.

Although dialysis (search) patients face a greater risk of death following a heart attack, researchers found that they were half as likely to receive standard treatment after suffering a heart attack (search) than the general population.

“The difference between the treatment of dialysis and non-dialysis patients appears to be based primarily on their status as dialysis patients,” says researcher David Charytan, MD, clinical and research fellow at Brigham and Women’s Hospital in Boston, in a news release. “Physicians seem to be more reluctant to prescribe invasive but potentially lifesaving therapies for dialysis patients than for their other patients.”

Charytan presented the results of his study this week at the annual meeting of the American Society of Nephrology in St. Louis.

Dialysis May Affect Heart Attack Treatment

Dialysis is a process that artificially filters toxins from the blood and is used when the kidneys are no longer able clean the blood adequately.

In the study, researchers compared the use of aggressive heart attack treatment, such as examining the arteries using angiography or bypassing clogged arteries in a heart bypass operation (search), among 2,369 dialysis patients and about 150,000 non-dialysis patients who were admitted to the hospital for a heart attack in 2001.

The study showed that dialysis patients were 43 percent less likely to have their arteries studied using angiography and 56 percent less likely to receive heart bypass surgery.

Compared with drug treatment alone, use of angiography and invasive heart procedures were associated with a lower risk of death in both dialysis and non-dialysis patients. For example, 7.8 percent of dialysis patients who had angiography died compared with 16.6 percent who had drug treatment alone.

Researchers say the finding suggests that the underutilization of aggressive heart attack treatments may contribute dialysis patients’ higher risk of death after a heat attack.

“In light of these findings, doctors should evaluate their practices and consider more frequent use of angiography, bypass surgery, and other coronary interventions in dialysis patients,” says Charytan.

By  Jennifer Warner, reviewed by  Brunilda Nazario, MD

SOURCES: American Society of Nephrology’s 27th Annual Meeting and Scientific Exposition, St. Louis, Oct. 27-Nov. 1, 2004. News release, American Society of Nephrology.