Long-term prognosis of chronic kidney disease in non-ST elevation acute coronary syndrome treated with invasive strategy
Por:
Roldán Torres I, Salvador Mercader I, Cabadés Rumbeu C, Díez Gil JL, Ferrando Cervelló J, Monteagudo Viana M, Fernández Galera R and Mora Llabata V
Publicada:
1 may 2017
Categoría:
Nephrology
Resumen:
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 < 60 ml/min/1,73m(2). 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 3 years. (C) 2016 Sociedad Espanola de Nefrologia. Published by Elsevier Espana, S.L.U.
Filiaciones:
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España.
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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Servicio de Cardiología, Hospital Universitario Dr. Peset, Valencia, España
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