1. Chapter 4: Cardiovascular Disease in Patients With CKD 2014 A NNUAL D ATA R EPORT V OLUME 1: C HRONIC K IDNEY D ISEASE

2. vol1 Figure 4.1 Cardiovascular disease in patients with or without CKD, 2012 Vol 1, CKD, Ch 4 2 Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: AFIB, atrial fibrillation; AMI, acute myocardial infarction; ASHD, atherosclerotic heart disease; CHF, congestive heart failure; CKD, chronic kidney disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; CVD, cardiovascular disease; PAD, peripheral arterial disease; SCA/VA, sudden cardiac arrest and ventricular arrhythmias.

3. vol1 Table 4.1 Prevalence of cardiovascular comorbidities & procedures (percent), by CKD status, age, race & sex, 2012 Vol 1, CKD, Ch 4 3 Cardiovascular Comorbidities a Overall66-6970-7475-8485+White Black / Af Am OtherMaleFemale Atherosclerotic heart disease (ASHD) Without CKD17.411.615.420.623.117.914.214.723.213.3 Any CKD42.935.239.544.846.143.936.440.150.236.3 Acute myocardial infarction (AMI) Without CKD2.41.72.12.73.32.51.91.63.11.9 Any CKD10.69.7 10.611.811.08.98.112.68.9 Congestive heart failure (CHF) Without CKD6.73.34.57.614.06.78.15.46.96.6 Any CKD30.122.224.329.439.530.132.326.430.230.1 Cerebrovascular accident/transient ischemic attack (CVA-TIA) Without CKD7.54.35.99.112.17.58.56.47.57.6 Any CKD19.114.716.220.021.918.921.417.819.019.2 Peripheral artery disease (PAD) Without CKD9.14.66.410.517.99.210.17.19.29.1 Any CKD26.419.522.426.832.026.626.222.927.325.6 Atrial fibrillation (AFIB) Without CKD9.64.36.611.918.010.34.85.310.88.7 Any CKD24.214.118.225.032.326.014.616.126.522.1 Cardiac arrest and ventricular arrhythmias (SCA/VA) Without CKD1.30.91.21.6 1.41.10.81.90.9 Any CKD4.54.04.54.84.34.64.52.96.23.0 Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. a The denominators for all cardiovascular comorbidities are Medicare enrollees age 66+. Abbreviations: AFIB, atrial fibrillation; AMI, acute myocardial infarction; ASHD, atherosclerotic heart disease; CHF, congestive heart failure; CKD, chronic kidney disease; CVA/TIA, cerebrovascular accident/transient ischemic attack; PAD, peripheral arterial disease; SCA/VA, sudden cardiac arrest and ventricular arrhythmias; CVD, cardiovascular disease; Af Am, African American.

4. vol1 Table 4.1 Prevalence of cardiovascular comorbidities & procedures (percent), by CKD status, age, race & sex, 2012 (cont.) Vol 1, CKD, Ch 4 4 Cardiovascular Procedures b Overall66-6970-7475-8485+White Black / Af Am OtherMaleFemale Revascularization - percutaneous coronary interventions (PCI) Without CKD4.26.25.13.92.14.33.53.84.73.6 Any CKD5.37.86.75.53.35.44.74.85.94.6 Revascularization - coronary artery bypass graft (CABG) Without CKD1.11.71.41.10.31.20.80.91.40.8 Any CKD1.82.92.81.90.61.91.3 2.21.2 Implantable cardioverter defibrillators & cardiac resynchronization therapy with defibrillator (ICD/CRT-D) Without CKD0.81.41.10.90.30.80.50.81.30.4 Any CKD1.22.01.81.50.51.30.91.21.90.6 Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. b The denominators for PCI and CABG are Medicare enrollees age 66+ with ASHD. The denominator for ICD/CRT-D is Medicare enrollees age 66+ with CHF. Abbreviations: Af Am, African American; CKD, chronic kidney disease; CVD, cardiovascular disease; CABG, coronary artery bypass grafting; ICD/CRT-D, implantable cardioverter defibrillators/cardiac resynchronization therapy with defibrillator devices; PCI, percutaneous coronary interventions.

5. vol1 Figure 4.2 Survival of patients with a cardiovascular diagnosis or procedure, by CKD status, 2010-2012 Vol 1, CKD, Ch 4 5 ASHD AMI Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: AMI, acute myocardial infarction; ASHD, atherosclerotic heart disease; CKD, chronic kidney disease.

6. vol1 Figure 4.2 Survival of patients with a cardiovascular diagnosis or procedure, by CKD status, 2010-2012 (cont.) Vol 1, CKD, Ch 4 6 CHF CVA / TIA Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: CHF, congestive heart failure; CKD, chronic kidney disease; CVA/TIA, cerebrovascular accident/transient ischemic attack.

7. vol1 Figure 4.2 Survival of patients with a cardiovascular diagnosis or procedure, by CKD status, 2010-2012 (cont.) Vol 1, CKD, Ch 4 7 PAD AFIB Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: AFIB, atrial fibrillation; CKD, chronic kidney disease; PAD, peripheral arterial disease.

8. vol1 Figure 4.2 Survival of patients with a cardiovascular diagnosis or procedure, by CKD status, 2010-2012 (cont.) Vol 1, CKD, Ch 4 8 SCA/VA PCI Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: CKD, chronic kidney disease; PCI, percutaneous coronary interventions; SCA/VA, sudden cardiac arrest and ventricular arrhythmias.

9. vol1 Figure 4.2 Survival of patients with a cardiovascular diagnosis or procedure, by CKD status, 2010-2012 (cont.) Vol 1, CKD, Ch 4 9 CABG ICD / CRT / D Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: CABG, coronary artery bypass grafting; CKD, chronic kidney disease; ICD/CRT-D, implantable cardioverter defibrillators/cardiac resynchronization therapy with defibrillator devices.

10. vol1 Table 4.2 Characteristics of patients with heart failure, by CKD status, 2012 Vol 1, CKD, Ch 4 10 Systolic +/- Diastolic heart failure Diastolic only heart failureHeart failure, unspecified Without CKDAny CKDWithout CKDAny CKDWithout CKDAny CKD Age: 66-6913.910.2 9.410.59.0 70-7418.216.915.214.015.714.9 75-8439.640.539.039.137.238.8 85+28.332.435.737.436.637.3 Male 52.756.331.135.339.045.4 Female 47.343.768.964.761.054.6 White 88.084.187.784.186.082.4 Black/African American 7.711.28.311.49.212.1 Other race4.34.74.14.54.85.5 Non-diabetes61.443.661.742.962.045.3 Diabetes 38.656.438.357.138.054.7 Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviation: CKD, chronic kidney disease.

11. vol1 Figure 4.3 Heart failure in patients with or without CKD, 2012 Vol 1, CKD, Ch 4 11 Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviation: CKD, chronic kidney disease.

12. vol1 Table 4.3 Adjusted hazard ratio of all-cause death (a) associated with the presence of CHF in patients with CKD, and (b) associated with the presence of CKD in patients with CHF, 2011-2012 Vol 1, CKD, Ch 4 12 (a) Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: CKD, chronic kidney disease; CHF, congestive heart failure. Hazard ratio Confidence Intervalp-value Age:66-69 reference 70-741.251.18 - 1.33<.0001 75-841.831.74 - 1.93<.0001 85+3.633.44 - 3.82<.0001 Male reference Female 0.830.81 - 0.85<.0001 White reference Black/African American0.950.92 - 0.990.0223 Other race0.820.77 - 0.87<.0001 CHFYes vs. No2.572.50 - 2.63<.0001 DiabetesYes vs. No1.081.06 - 1.11<.0001 HypertensionYes vs. No0.880.83 - 0.92<.0001

13. vol1 Table 4.3 Adjusted hazard ratio of all-cause death (a) associated with the presence of CHF in patients with CKD, and (b) associated with the presence of CKD in patients with CHF, 2011-2012 (cont.) Vol 1, CKD, Ch 4 13 (b) Data Source: Medicare 5 percent sample. Patients age 66 and older, alive, without end-stage renal disease, and residing in the U.S. on 12/31/2012 with fee-for-service coverage for the entire calendar year. Abbreviations: CKD, chronic kidney disease; CHF, congestive heart failure. Hazard ratio Confidence Intervalp-value Age:66-69 reference 70-741.181.11 - 1.25<.0001 75-841.741.66 - 1.83<.0001 85+3.303.14 - 3.47<.0001 Male reference Female 0.870.85 - 0.89<.0001 White reference Black/African American0.890.85 - 0.92<.0001 Other race0.760.72 - 0.81<.0001 CKDYes vs. No1.521.49 - 1.56<.0001 DiabetesYes vs. No1.091.07 - 1.12<.0001 HypertensionYes vs. No0.910.88 - 0.94<.0001