Impact of Renal Dysfunction on Clinical Outcomes of Acute Coronary Syndrome
Yonsei Medical Journal
;
: 537-545, 2009.
Article
in English
| WPRIM
| ID: wpr-178608
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 ANDMETHODS:
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.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Proportional Hazards Models
/
Retrospective Studies
/
Risk Factors
/
Coronary Angiography
/
Acute Coronary Syndrome
/
Glomerular Filtration Rate
/
Kidney Diseases
/
Kidney Function Tests
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Aged
/
Female
/
Humans
/
Male
Language:
English
Journal:
Yonsei Medical Journal
Year:
2009
Type:
Article
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