{
  "abstract": "Introduction Ischaemic heart disease (IHD) imposes a significant global health and socioeconomic burden. Renal impairment is known to pose a challenge in the management of IHD and negatively influences the outcomes. Therefore, is it of vital importance to evaluate the temporal trends in the impact of renal impairment on IHD related mortality and disability adjusted life years (DALY) to enable risk stratification and tailored management.Methods Data from the Global burden of Disease database was retrieved to evaluate the temporal trends in the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of IHD that is attributed to renal impairment in the US for the period 1990-2021. The Annual Percent Change (APC) and the Average Annual Percent Change (AAPC) were calculated using Joinpoint analysis software.Results Over the period 1990-2021, an estimated total of 16,872,006 IHD-related deaths were reported in the US with renal impairment attributing to 19.3% of those deaths. A statistically significant decline in IHD ASMR attributed to renal impairment was observed in the US (AAPC -2.45, 95%CI -2.50 to -2.40, p<0.001). Gender stratification revealed statistically significant decline in the ASMR in both, males (AAPC -2.41, 95%CI -2.46 to -2.35, p<0.001) and females (AAPC -2.60, 95%CI -2.65 to -2.55, p<0.001). Stratification at a state level revealed a statistically significant decline in the ASMR across all states, with the highest decline noted in Oregon (AAPC -2.30) followed by California (AAPC -2.94), Massachusetts (AAPC -2.92), Illinois (AAPC -2.82), New York (AAPC -2.73) and Alaska (AAPC -2.73). Regarding ASDR, a statistically significant decline was also observed in the US with an AAPC of -2.40 (95%CI -2.45 to -2.34, p<0.001). Stratification by gender revealed a statistically significant decline in both, males (AAPC -2.42, 95%CI -2.49 to -2.35, p<0.001) and females (AAPC -2.52, 95%CI -2.56 to -2.47, p<0.001).Conclusion Overall, the US experienced a significant decline in the burden of ischemic heart disease attributed to renal impairment in the US for the period 1990-2021. Evaluating the factors leading to this decline is warranted to enable reciprocation in other nations around the globe.",
  "authors": [
    {
      "affiliations": [
        "Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom"
      ],
      "name": "Zaid Abdulelah"
    },
    {
      "affiliations": [
        "St George’s University Hospitals NHS Foundation Trust, London, United Kingdom"
      ],
      "name": "Ahmed Abdulelah"
    },
    {
      "affiliations": [
        "Medstar Health Georgetown University (Baltimore), Baltimore, United States"
      ],
      "name": "Ahmad Alkhatib"
    },
    {
      "affiliations": [
        "East Tennessee State University, Johnson City, United States"
      ],
      "name": "Mohammad Al-Dqour"
    }
  ],
  "title": "384 The impact of renal impairment on the burden of ischaemic heart disease in the United States: temporal analysis of the past 3 decades",
  "uid": "697c37fd-c563-53cc-877b-4828679486e6"
}