Key result
Mild renal insufficiency linked to ~27% higher in-hospital MACE risk vs normal renal function.
Why the study?
Renal insufficiency is a frequent comorbidity in ACS, but the attributable risk associated with mild renal insufficiency for in-hospital outcomes remained to be evaluated.
Does mild renal insufficiency increase the risk of in-hospital major adverse cardiovascular events in patients with acute coronary syndrome?
Observational (n=92,509)
Yes
Does mild renal insufficiency increase the risk of in-hospital major adverse cardiovascular events in patients with acute coronary syndrome?
Mild renal insufficiency carries a higher attributable risk for in-hospital MACEs than moderate-to-severe renal insufficiency in patients with ACS, highlighting the population-level impact of early-stage kidney disease.
Mild renal insufficiency may warrant closer ACS monitoring; leaves open whether early CKD screening improves outcomes.
Background Renal insufficiency (RI) is a frequent comorbidity among patients with acute coronary syndrome (ACS). We aimed to evaluate the attributable risk associated with mild RI for the in-hospital outcomes in patients with ACS. Methods The Improving Care for Cardiovascular Disease in China-ACS (CCC-ACS) Project was a collaborative study of the American Heart Association and the Chinese Society of Cardiology. A total of 92,509 inpatients with a discharge diagnosis of ACS were included. The attributable risk was calculated to investigate the effect of mild RI (eGFR 60-89 ml / min · 1.73 m 2 ) on major adverse cardiovascular events (MACEs) during hospitalization. Results The average age of these ACS patients was 63 years, and 73.9% were men. The proportion of patients with mild RI was 36.17%. After adjusting for other possible risk factors, mild RI was still an independent risk factor for MACEs in ACS patients. In the ACS patients, the attributable risk of eGFR 60-89ml/min·1.73m 2 to MACEs was 7.78%, 4.69% of eGFR 45-59 ml/min·1.73m 2 , 4.46% of eGFR 30-44 ml/min·1.73m 2 , and 3.36% of eGFR<30 ml/min·1.73m 2 . Conclusion Compared with moderate to severe RI, mild RI has higher attributable risk to MACEs during hospitalization in Chinese ACS population.
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Xu et al. (2022) conducted an observational in Acute Coronary Syndrome (ACS) (n=92,509). Mild renal insufficiency (eGFR 60-89 ml/min·1.73m2) vs. Normal renal function (eGFR ≥90 ml/min·1.73m2) was evaluated on Major adverse cardiovascular events (MACEs) during hospitalization (OR 1.27, 95% CI 1.19-1.35, p=<0.001). Mild renal insufficiency independently increased the risk of in-hospital major adverse cardiovascular events by 27% (OR 1.27) compared to normal renal function, with an attributable risk of 7.78%.
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