Key result
Severe renal dysfunction (eGFR <30 mL/min per 1.73 m2) on admission was associated with a significantly higher risk of in-hospital death in ACS patients (OR 3.1; 95% CI 1.1-8.4; P=0.0324).
Why the study?
Does lower eGFR calculated by the CKD-EPI formula predict in-hospital adverse clinical outcomes in patients with acute coronary syndrome?
Cohort (n=5,034)
Does lower eGFR calculated by the CKD-EPI formula predict in-hospital adverse clinical outcomes in patients with acute coronary syndrome?
Odds Ratio: 3.1 (95% CI 1.1–8.4)
p-value: p=0.0324
Admission eGFR calculated by the CKD-EPI formula is an independent predictor of major adverse cardiac outcomes, including in-hospital death, in patients with ACS.
May aid ACS risk stratification on admission; supports eGFR as prognostic marker but leaves open whether targeted interventions improve outcomes.
The prognostic value of admission estimated glomerular filtration rate (eGFR) calculated by the new Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula for cardiovascular adverse outcomes in acute coronary syndrome (ACS) was explored. Baseline eGFR was classified as no renal dysfunction (>90 mL/min per 1.73 m(2)), borderline (90-60.1 mL/min per 1.73 m(2)), moderate (60-30.1 mL/min per 1.73 m(2)), or severe (≤30 mL/min per 1.73 m(2)) renal dysfunction. Of the 5034 patients, 3415 (67.8%) had eGFR <90. Compared to patients with an eGFR ≥60 mL/min per 1.73 m(2), patients with <60 mL/min per 1.73 m(2) were less likely to be treated with β-blockers, angiotensin-converting enzyme inhibitors, or statins, or to undergo percutaneous coronary interventions. Lower eGFR showed a stepwise association with significantly worse adverse in-hospital outcomes. The adjusted odds ratio of in-hospital death with an eGFR <30 mL/min per 1.73 m(2) was 3.1 (95% confidence interval 1.1-8.4, P = .0324), compared with an eGFR >90 mL/min per 1.73 m(2). Estimated glomerular filtration rate calculated by the new CKD-EPI is an independent predictor of major adverse cardiac outcomes in patients with ACS.
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AlFaleh et al. (2011) conducted a cohort in Acute coronary syndrome (n=5,034). Severe renal dysfunction (eGFR <30 mL/min per 1.73 m2) vs. No renal dysfunction (eGFR >90 mL/min per 1.73 m2) was evaluated on In-hospital death (OR 3.1, 95% CI 1.1-8.4, p=0.0324). Severe renal dysfunction (eGFR <30 mL/min per 1.73 m2) on admission was associated with a significantly higher risk of in-hospital death in ACS patients (OR 3.1; 95% CI 1.1-8.4; P=0.0324).
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