The prognostic impact of in-hospital worsening of renal function in patients with acute coronary syndrome

被引:18
作者
AlFaleh, Hussam F. [1 ]
Alsuwaida, Abdulkareem O. [2 ]
Ullah, Anhar [3 ]
Hersi, Ahmad [1 ]
AlHabib, Khalid F. [1 ]
AlNemer, Khalid [3 ]
AlSaif, Shukri [4 ]
Taraben, Amir [5 ]
Kashour, Tarek [6 ]
Balghith, Mohammed A. [7 ]
Ahmed, Waqar H. [8 ]
机构
[1] King Saud Univ, Cardiac Sci Dept, Coll Med, King Khalid Univ Hosp, Riyadh 11472, Saudi Arabia
[2] King Saud Univ, Dept Med, Coll Med, King Khalid Univ Hosp, Riyadh 11472, Saudi Arabia
[3] Secur Forces Hosp, Dept Med, Riyadh, Saudi Arabia
[4] Saud AlBabtain Cardiac Ctr, Dammam, Saudi Arabia
[5] King Faisal Specialist Hosp & Res Ctr, Jeddah, Saudi Arabia
[6] King Fahd Med City, Prince Salman Heart Ctr, Riyadh, Saudi Arabia
[7] King Abdul Aziz Med City, Cardiac Ctr, Natl Guard, Riyadh, Saudi Arabia
[8] King Fahd Armed Forces Hosp, Jeddah, Saudi Arabia
关键词
Acute coronary syndrome; Worsening renal function; Cardiovascular outcomes; ACUTE MYOCARDIAL-INFARCTION; GLOMERULAR-FILTRATION-RATE; CHRONIC KIDNEY-DISEASE; CREATININE CLEARANCE; CARDIOVASCULAR-DISEASE; OUTCOMES; MORTALITY; REGISTRY; INSUFFICIENCY; ASSOCIATION;
D O I
10.1016/j.ijcard.2012.01.097
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Renal impairment is strongly linked to adverse cardiovascular (CV) events. Baseline renal dysfunction is a strong predictor of CV mortality and morbidity in patients admitted with acute coronary syndrome (ACS). However, the prognostic importance of worsening renal function (WRF) in these patients is not well characterized. Methods: ACS patients enrolled in the SPACE (Saudi Project for Assessment of Coronary Events) registry who had baseline and pre-discharge serum creatinine data available were eligible for this study. WRF was defined as a 25% reduction from admission estimated glomerular filtration rate (eGFR) within 7 days of hospitalization. Baseline demographics, clinical presentation, therapies, and in-hospital outcomes were compared. Results: Of the 3583 ACS patients, WRF occurred in 225 patients (6.3%), who were older, had more cardiovascular risk factors, were more likely to be female, have past vascular disease, and presented with more non-ST-segment elevation myocardial infarction than patients without WRF (39.5% vs. 32.8%; p = 0.042). WRF was associated with an increased risk of in-hospital death, heart failure, cardiogenic shock, and stroke. After adjusting for potential confounders, WRF was an independent predictor of in-hospital death (adjusted odd ratio 28.02, 95% CI 13.2-60.28, p<0.0001). WRF was more predictive of mortality than baseline eGFR. Conclusion: These results indicate that WRF is a powerful predictor for in-hospital mortality and CV complications in ACS patients. (C) 2012 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:866 / 870
页数:5
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