title: Diagnosis and management of atherosclerotic cardiovascular disease in chronic kidney disease: a review.
abstract: Patients with chronic kidney disease (CKD) have a high prevalence of atherosclerotic cardiovascular disease, likely reflecting the presence of traditional risk factors. A greater distinguishing feature of atherosclerotic cardiovascular disease in CKD is the severity of the disease, which is reflective of an increase in inflammatory mediators and vascular calcification secondary to hyperparathyroidism of renal origin that are unique to patients with CKD. Additional components of atherosclerotic cardiovascular disease that are prominent in patients with CKD include microvascular disease and myocardial fibrosis. Therapeutic interventions that minimize cardiovascular events related to atherosclerotic cardiovascular disease in patients with CKD, as determined by well-designed clinical trials, are limited to statins. Data are lacking regarding other available therapeutic measures primarily due to exclusion of patients with CKD from major trials studying cardiovascular disease. Data from well-designed randomized controlled trials are needed to guide clinicians who care for this high-risk population in the management of atherosclerotic cardiovascular disease to improve clinical outcomes.
authors.affiliation: Division of Nephrology, Department of Medicine, WJB Dorn VA Medical Center, Columbia, South Carolina, USA. Electronic address: roy.mathew@va.gov.
authors.forename: Roy O
authors.initials: RO
authors.lastname: Mathew
authors.affiliation: Division of Cardiology, New York University School of Medicine, New York, New York, USA.
authors.forename: Sripal
authors.initials: S
authors.lastname: Bangalore
authors.affiliation: Albany Medical College, Albany, New York, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Lavelle
authors.affiliation: Department of Cardiology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Pellikka
authors.affiliation: Division of Cardiology, Department of Medicine, Stratton VA Medical Center, Albany, New York, USA; Division of Cardiology, Department of Medicine, Albany Medical College, Albany, New York, USA.
authors.forename: Mandeep S
authors.initials: MS
authors.lastname: Sidhu
authors.affiliation: Division of Cardiology, Department of Medicine, Stratton VA Medical Center, Albany, New York, USA; Division of Cardiology, Department of Medicine, Albany Medical College, Albany, New York, USA.
authors.forename: William E
authors.initials: WE
authors.lastname: Boden
authors.affiliation: Department of Medicine, Jersey Shore University Medical Center, Neptune, New Jersey, USA.
authors.forename: Arif
authors.initials: A
authors.lastname: Asif
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D015897:Comorbidity; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D011237:Predictive Value of Tests; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: atherosclerotic cardiovascular disease; chronic kidney disease; diagnosis; medical management; percutaneous coronary intervention