Key result
In patients with acute coronary syndrome, advanced chronic kidney disease stage was associated with decreased unadjusted median survival (78 vs 61 vs 40 months; p=0.014), but not after adjustment.
Why the study?
Patients with CKD are at increased cardiovascular risk, prompting evaluation of long-term outcomes in patients with ACS.
Cohort (n=401)
p-value: p=0.014
In patients with acute coronary syndrome and chronic kidney disease, long-term mortality is associated with comorbidities like age and pulmonary artery systolic pressure rather than the estimated glomerular filtration rate.
Worse unadjusted survival with advancing CKD stage in ACS; after adjustment, comorbidities—not eGFR—predicted mortality, leaving independent prognostic role open.
Aim: Patients with chronic kidney disease (CKD) are at increased cardiovascular risk. Methods: Patients with acute coronary syndrome were retrospectively allocated to three groups (stage 3A, stage 3B or stage 4) based on the Kidney Disease Improving Global Outcomes classification formulas: the CKD Epidemiology Collaboration (CKD-EPI; N = 401) and the modification of diet in renal disease (n = 355). The primary end point was all-cause mortality (median follow-up time, 32 months [15–70]). Results: Study results showed decreased median survival was associated with poor renal function for both the CKD-EPI (78 vs 61 vs 40 months, p = 0.014) and modification of diet in renal disease groups (68 vs 57 vs 32 months, p = 0.006). After adjustment, age (OR: 1.07; 95% CI: 1.01–1.14) and pulmonary artery systolic pressure (OR: 1.08; 95% CI: 1.03–1.14), but not estimated glomerular filtration rate, were associated with decreased survival. Conclusion: Study results suggest that poor outcomes after an acute coronary syndrome were associated with comorbidities rather than estimated glomerular filtration rate level.
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Saleiro et al. (2021) conducted a cohort in Acute coronary syndrome and chronic kidney disease (n=401). Chronic kidney disease stage (3A, 3B, or 4) vs. Different stages of chronic kidney disease was evaluated on All-cause mortality (p=0.014). In patients with acute coronary syndrome, advanced chronic kidney disease stage was associated with decreased unadjusted median survival (78 vs 61 vs 40 months; p=0.014), but not after adjustment.
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