Renal dysfunction as an independent predictor of total mortality after acute coronary syndrome: the Thai ACS Registry.

BACKGROUND: Renal insufficiency in the acute coronary syndrome (ACS) is associated with poor cardiac outcome. In Asian populations, there are no data available for these associations. MATERIAL AND METHOD: Data was from the Thai ACS registry, only a new case of ACS. Clinical characteristics, treatment strategies, in-hospital mortality and 1-year mortality were compared for patients with normal or mild renal dysfunction (estimated glomerular filtration rate [eGFR]> 60 ml/minute/1.73 m2, n = 809 [44.5%]), moderate renal dysfunction (eGFR 30-60 ml/minute/1.73 m2, n = 706 [38.9%]), and severe renal dysfunction (eGFR < 30 ml/minute/1.73 m2, n = 301 [16.6%]). RESULTS: Of the 1,816patients with mean follow-up 10.8 months, the mean age was 65 years, and 59.2 percent of the groups were male. Patients with severe renal dysfunction were significantly older, less likely to be male (45.2%, p < 0.001) and had a greater prevalence of diabetes (63.1%, p < 0.001) and hypertension (85.4%, p < 0.001). In-hospital and 1-year mortality were 13.5% and 22.5% respectively. According to discharge diagnosis, unadjusted hazard ratios for overall in-hospital mortality was statistically significant only in ST elevation MI subgroup, hazard ratio was 2.73 (95% CI, 1.72 to 4.34) and 6.27 (95% CI, 3.78 to 10.4) for moderate and severe renal dysfunction group, respectively. The risk of death for all types of ACS at 1-year follow up increased when eGFR decreased below 60 ml/minute/1.73 m2, the adjusted hazard ratio was 1.66 (95% CI,1.22 to 2.23) and 1.91 (95% CI, 1.34 to 2.72) for moderate and severe renal dysfunction group, respectively. CONCLUSION: From Thai ACS registry, renal dysfunction at presentation is an independent predictor for the overall 1-year mortality and appeared to associate with an increase in hospital mortality in the subsets with STEMI

Histologic subtypes of hepatocellular carcinoma in the southern Thai population.

Since there has been no report on histologic subtypes of hepatocellular carcinoma (HCC) and its significance in the Thai population, the present study was conducted to elucidate the situation through appraisal of histologic and laboratory records. A total of 180 archived microscopic slides of HCC in Sonklanagarind Hospital from 1991 to 1998 were of good enough quality with sufficient tissue to be reviewed. The reclassified histologic subtypes were correlated with microscopic features and laboratory data. Of the 180 cases, 147 were males and hepatitis B was the main etiologic factor. The histologic subtypes of HCC were trabecular 63.3%, compact 15.6%, scirrhous 7.8%, pseudoglandular 5%, and fibrolamellar 0.6%. There was no correlation between histologic subtypes and morphological findings, as well as HBV, HCV, and cirrhotic status. A correlation between AFP levels and the AST/ALT ratio was evident.