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. 2009 Aug 31;50(4):537-45.
doi: 10.3349/ymj.2009.50.4.537. Epub 2009 Aug 19.

Impact of renal dysfunction on clinical outcomes of acute coronary syndrome

Yong Un Kang  1 , Myung Ho Jeong, Soo Wan Kim
Affiliations

Impact of renal dysfunction on clinical outcomes of acute coronary syndrome

Yong Un Kang et al. Yonsei Med J. .

Abstract

Purpose: The present study aimed to compare the clinical outcomes and to investigate prognostic factors of acute coronary syndrome (ACS) in patients with renal dysfunction (RD).

Materials and methods: The study was a retrospective cohort of 648 adult patients admitted with ACS between October 2005 and December 2006. The estimated glomerular filtration rate (GFR) was classified into 4 levels: 1) normal, GFR greater than 90 mL/min/1.73 m(2); 2) mild RD, GFR of 60 to 90 mL/min/1.73 m(2); 3) moderate RD, GFR of 30 to 60 mL/min/1.73 m(2); and 4) severe RD, GFR less than 30 mL/min/1.73 m(2). Primary end points were death and complication in hospital courses. Secondary end points were major adverse cardiac event (MACE) during follow-up.

Results: The median follow-up was 505 +/- 183 days, the mean age was 63 +/- 12 years, and 71.8 percent of the group were men. A graded association was observed between severity of RD and clinical outcomes. Severe RD independently predicted MACE [hazard ratio, 2.731; 95% confidence interval (CI), 1.058 to 7.047, p = 0.038]. Low hemoglobin level was also an independent risk factor for MACE (hazard ratio, 1.155; 95% CI, 1.020 to 1.307, p = 0.022). Use of lipid-lowering therapy (hazard ratio, 0.456; 95% CI, 0.242 to 0.857, p = 0.015) was associated with reduced risk for MACE.

Conclusion: Severe RD and low hemoglobin level were an independent risk factors for the mortality and complications of ACS, while lipid-lowering therapy was associated with reduced risk.

Keywords: Acute coronary syndrome; glomerular filtration rate; risk factors.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Kaplan-Meier survival in patients with acute coronary syndrome according to renal function during follow-up. Severe renal dysfunction group showed lower probability of event-free survival than the other groups.
See this image and copyright information in PMC

References

    1. Sarnak MJ, Levey AS, Schoolwerth AC, Coresh J, Culleton B, Hamm LL, et al. Kidney disease as a risk factor for development of cardiovascular disease: a statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension. 2003;42:1050–1065. - PubMed
    1. Tonelli M, Wiebe N, Culleton B, House A, Rabbat C, Fok M, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol. 2006;17:2034–2047. - PubMed
    1. Muntner P, He J, Hamm L, Loria C, Whelton PK. Renal insufficiency and subsequent death resulting from cardiovascular disease in the United States. J Am Soc Nephrol. 2002;13:745–753. - PubMed
    1. Manjunath G, Tighiouart H, Ibrahim H, MacLeod B, Salem DN, Griffith JL, et al. Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community. J Am Coll Cardiol. 2003;41:47–55. - PubMed
    1. Anavekar NS, McMurray JJ, Velazquez EJ, Solomon SD, Kober L, Rouleau JL, et al. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N Engl J Med. 2004;351:1285–1295. - PubMed

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