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Nefrologia. 2017 May - Jun;37(3):276-284. doi: 10.1016/j.nefro.2016.11.011.

Long-term prognosis of chronic kidney disease in non-ST elevation acute coronary syndrome treated with invasive strategy.

[Article in English, Spanish]

Author information

1
Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España. Electronic address: il.roldant@comv.es.
2
Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España.

Abstract

BACKGROUND AND AIM:

Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular outcomes after non-ST elevation acute coronary syndrome (NSTEACS). However, the information available on this specific population, is scarce. We evaluate the impact of CKD on long-term prognosis in patients with NSTEACS managed with invasive strategy.

METHODS:

We conduct a prospective registry of patients with NSTEACS and coronary angiography. CKD was defined as a glomerular filtration rate < 60ml/min/1,73m2. The composite primary end-point was cardiac death and non fatal cardiovascular readmission. We estimated the cumulative probability and hazard rate (HR) of combined primary end-point at 3-years according to the presence or absence of CKD.

RESULTS:

We included 248 p with mean age of 66.9 years, 25% women. CKD was present at baseline in 67 patients (27%). Patients with CKD were older (74.9 vs. 63.9 years; P<.0001) with more prevalence of hypertension (89.6 vs. 66.3%; P<.0001), diabetes (53.7 vs. 35.9%; P=.011), history of heart failure (13.4 vs. 3.9%; P=.006) and anemia (47.8 vs. 16%; P<.0001). No differences in the extent of coronary artery disease. CKD was associated with higher cumulative probability (49.3 vs. 28.2%; log-rank P=.001) and HR of the primary combined end-point (HR: 1.94; CI95%: 1.12-3.27; P=.012). CKD was an independent predictor of adverse cardiovascular outcomes at 3-years (HR: 1.66; CI95%: 1.05-2.61; P=.03).

CONCLUSIONS:

In NSTEACS patients treated with invasive strategie CKD is associated independently with an increased risk of adverse cardiovascular outcomes at 3years.

KEYWORDS:

Acute coronary syndrome; Chronic kidney disease; Enfermedad renal crónica; Estrategia invasiva; Invasive management; Prognosis; Pronóstico; Síndrome coronario agudo

PMID:
28648204
DOI:
10.1016/j.nefro.2016.11.011
[Indexed for MEDLINE]
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