Why the study?
Renal insufficiency is a frequent comorbidity in acute coronary syndrome, 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 major adverse cardiovascular events during hospitalization in patients with acute coronary syndrome?
Does mild renal insufficiency increase the risk of major adverse cardiovascular events during hospitalization in patients with acute coronary syndrome?
Mild renal insufficiency is an independent risk factor for in-hospital MACE in ACS patients and carries a higher attributable risk than moderate-to-severe renal insufficiency due to its high prevalence.
Mild RI warrants closer in-hospital monitoring in ACS; leaves open whether targeted interventions improve 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 92509 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 (MACE) 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 MACE in ACS patients. In the ACS patients, the attributable risk of eGFR 60-89ml/min·1.73m 2 to MACE was 8.96%, 5.59% of eGFR 45-59 ml/min·1.73m 2 ,5.31% of eGFR 30-44 ml/min·1.73m 2 , and 4.03% of eGFR＜30 ml/min·1.73m 2 . Conclusion: Compared with moderate to severe RI, mild RI has higher attributable risk to MACE during hospitalization in Chinese ACS population.
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Xu et al. (2021) studied this question.
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