Impact of Renal Dysfunction on Clinical Outcomes of Acute Coronary Syndrome.
10.3349/ymj.2009.50.4.537
- Author:
Yong Un KANG
1
;
Myung Ho JEONG
;
Soo Wan KIM
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. skimw@chonnam.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Acute coronary syndrome;
glomerular filtration rate;
risk factors
- MeSH:
Acute Coronary Syndrome/*pathology;
Aged;
Coronary Angiography;
Female;
Glomerular Filtration Rate/physiology;
Humans;
Kidney Diseases/*physiopathology;
Kidney Function Tests;
Male;
Middle Aged;
Proportional Hazards Models;
Retrospective Studies;
Risk Factors
- From:Yonsei Medical Journal
2009;50(4):537-545
- CountryRepublic of Korea
- Language:English
-
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 m2; 2) mild RD, GFR of 60 to 90 mL/min/1.73 m2; 3) moderate RD, GFR of 30 to 60 mL/min/1.73 m2; and 4) severe RD, GFR less than 30 mL/min/1.73 m2. 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.
