Abstract 18741: Achievement of Guideline-Directed Medical Therapy in Stable Ischemic Heart Disease Patients With and Without Chronic Kidney Disease

Introduction: The prevalence of coronary artery disease (CAD) is increased significantly in patients with chronic kidney disease (CKD). There is a paucity of data on whether guideline-directed medical therapy (GDMT) is adequately implemented in the CAD patients with CKD. Hypothesis: Stable ischemic heart disease (SIHD) patients with CKD may be inadequately treated due to complexity of CKD management coupled with the necessity of drug adjustment and discontinuation when glomerular filtration rate (GFR) declines. To test this hypothesis, we compared rates of implementation of GDMT in SIHD patients with and without CKD. Methods: A retrospective cross-sectional study of 462 consecutive patients with SIHD was conducted between 01/2014 and 12/2015. CKD was defined as estimated GFR of < 60 ml/min/1.73m,2 based on MDRD equation, while non-CKD was defined as estimated GFR ≥60 ml/min/1.73m2. We examined the likelihood of achieving GDMT targets in patients with (n=169) and without CKD (n=293), using both univariate ...