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Renal dysfunction as an independent predictor of total mortality after acute coronary syndrome: the Thai ACS Registry.
J Med Assoc Thai. 2007 Oct; 90 Suppl 1:32-40.JM

Abstract

BACKGROUND

Renal insufficiency in the acute coronary syndrome (ACS) is associated with poor cardiac outcome. In Asian populations, there are no data available for these associations.

MATERIAL AND METHOD

Data was from the Thai ACS registry, only a new case of ACS. Clinical characteristics, treatment strategies, in-hospital mortality and 1-year mortality were compared for patients with normal or mild renal dysfunction (estimated glomerular filtration rate [eGFR]> 60 ml/minute/1.73 m2, n = 809 [44.5%]), moderate renal dysfunction (eGFR 30-60 ml/minute/1.73 m2, n = 706 [38.9%]), and severe renal dysfunction (eGFR < 30 ml/minute/1.73 m2, n = 301 [16.6%]).

RESULTS

Of the 1,816patients with mean follow-up 10.8 months, the mean age was 65 years, and 59.2 percent of the groups were male. Patients with severe renal dysfunction were significantly older, less likely to be male (45.2%, p < 0.001) and had a greater prevalence of diabetes (63.1%, p < 0.001) and hypertension (85.4%, p < 0.001). In-hospital and 1-year mortality were 13.5% and 22.5% respectively. According to discharge diagnosis, unadjusted hazard ratios for overall in-hospital mortality was statistically significant only in ST elevation MI subgroup, hazard ratio was 2.73 (95% CI, 1.72 to 4.34) and 6.27 (95% CI, 3.78 to 10.4) for moderate and severe renal dysfunction group, respectively. The risk of death for all types of ACS at 1-year follow up increased when eGFR decreased below 60 ml/minute/1.73 m2, the adjusted hazard ratio was 1.66 (95% CI,1.22 to 2.23) and 1.91 (95% CI, 1.34 to 2.72) for moderate and severe renal dysfunction group, respectively.

CONCLUSION

From Thai ACS registry, renal dysfunction at presentation is an independent predictor for the overall 1-year mortality and appeared to associate with an increase in hospital mortality in the subsets with STEMI

Authors+Show Affiliations

Division of Cardiology, Department of Medicine, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

18431884

Citation

Sooklim, Khorawit, et al. "Renal Dysfunction as an Independent Predictor of Total Mortality After Acute Coronary Syndrome: the Thai ACS Registry." Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, vol. 90 Suppl 1, 2007, pp. 32-40.
Sooklim K, Srimahachota S, Boonyaratavej S, et al. Renal dysfunction as an independent predictor of total mortality after acute coronary syndrome: the Thai ACS Registry. J Med Assoc Thai. 2007;90 Suppl 1:32-40.
Sooklim, K., Srimahachota, S., Boonyaratavej, S., Kanjanavanit, R., Siriviwattanakul, N., Piamsomboon, C., & Ratanaprakarn, R. (2007). Renal dysfunction as an independent predictor of total mortality after acute coronary syndrome: the Thai ACS Registry. Journal of the Medical Association of Thailand = Chotmaihet Thangphaet, 90 Suppl 1, 32-40.
Sooklim K, et al. Renal Dysfunction as an Independent Predictor of Total Mortality After Acute Coronary Syndrome: the Thai ACS Registry. J Med Assoc Thai. 2007;90 Suppl 1:32-40. PubMed PMID: 18431884.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal dysfunction as an independent predictor of total mortality after acute coronary syndrome: the Thai ACS Registry. AU - Sooklim,Khorawit, AU - Srimahachota,Suphot, AU - Boonyaratavej,Smonporn, AU - Kanjanavanit,Rungsrit, AU - Siriviwattanakul,Napa, AU - Piamsomboon,Chumpol, AU - Ratanaprakarn,Rangson, AU - ,, PY - 2008/4/25/pubmed PY - 2008/5/22/medline PY - 2008/4/25/entrez SP - 32 EP - 40 JF - Journal of the Medical Association of Thailand = Chotmaihet thangphaet JO - J Med Assoc Thai VL - 90 Suppl 1 N2 - BACKGROUND: Renal insufficiency in the acute coronary syndrome (ACS) is associated with poor cardiac outcome. In Asian populations, there are no data available for these associations. MATERIAL AND METHOD: Data was from the Thai ACS registry, only a new case of ACS. Clinical characteristics, treatment strategies, in-hospital mortality and 1-year mortality were compared for patients with normal or mild renal dysfunction (estimated glomerular filtration rate [eGFR]> 60 ml/minute/1.73 m2, n = 809 [44.5%]), moderate renal dysfunction (eGFR 30-60 ml/minute/1.73 m2, n = 706 [38.9%]), and severe renal dysfunction (eGFR < 30 ml/minute/1.73 m2, n = 301 [16.6%]). RESULTS: Of the 1,816patients with mean follow-up 10.8 months, the mean age was 65 years, and 59.2 percent of the groups were male. Patients with severe renal dysfunction were significantly older, less likely to be male (45.2%, p < 0.001) and had a greater prevalence of diabetes (63.1%, p < 0.001) and hypertension (85.4%, p < 0.001). In-hospital and 1-year mortality were 13.5% and 22.5% respectively. According to discharge diagnosis, unadjusted hazard ratios for overall in-hospital mortality was statistically significant only in ST elevation MI subgroup, hazard ratio was 2.73 (95% CI, 1.72 to 4.34) and 6.27 (95% CI, 3.78 to 10.4) for moderate and severe renal dysfunction group, respectively. The risk of death for all types of ACS at 1-year follow up increased when eGFR decreased below 60 ml/minute/1.73 m2, the adjusted hazard ratio was 1.66 (95% CI,1.22 to 2.23) and 1.91 (95% CI, 1.34 to 2.72) for moderate and severe renal dysfunction group, respectively. CONCLUSION: From Thai ACS registry, renal dysfunction at presentation is an independent predictor for the overall 1-year mortality and appeared to associate with an increase in hospital mortality in the subsets with STEMI SN - 0125-2208 UR - https://www.unboundmedicine.com/medline/citation/18431884/Renal_dysfunction_as_an_independent_predictor_of_total_mortality_after_acute_coronary_syndrome:_the_Thai_ACS_Registry_ L2 - https://medlineplus.gov/kidneydiseases.html DB - PRIME DP - Unbound Medicine ER -