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The prognostic impact of in-hospital worsening of renal function in patients with acute coronary syndrome.
Int J Cardiol. 2013 Aug 10; 167(3):866-70.IJ

Abstract

BACKGROUND

Renal impairment is strongly linked to adverse cardiovascular (CV) events. Baseline renal dysfunction is a strong predictor of CV mortality and morbidity in patients admitted with acute coronary syndrome (ACS). However, the prognostic importance of worsening renal function (WRF) in these patients is not well characterized.

METHODS

ACS patients enrolled in the SPACE (Saudi Project for Assessment of Coronary Events) registry who had baseline and pre-discharge serum creatinine data available were eligible for this study. WRF was defined as a 25% reduction from admission estimated glomerular filtration rate (eGFR) within 7 days of hospitalization. Baseline demographics, clinical presentation, therapies, and in-hospital outcomes were compared.

RESULTS

Of the 3583 ACS patients, WRF occurred in 225 patients (6.3%), who were older, had more cardiovascular risk factors, were more likely to be female, have past vascular disease, and presented with more non-ST-segment elevation myocardial infarction than patients without WRF (39.5% vs. 32.8%; p=0.042). WRF was associated with an increased risk of in-hospital death, heart failure, cardiogenic shock, and stroke. After adjusting for potential confounders, WRF was an independent predictor of in-hospital death (adjusted odd ratio 28.02, 95% CI 13.2-60.28, p<0.0001). WRF was more predictive of mortality than baseline eGFR.

CONCLUSION

These results indicate that WRF is a powerful predictor for in-hospital mortality and CV complications in ACS patients.

Authors+Show Affiliations

Cardiac Sciences Department, College of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. halfaleh@ksu.edu.saNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial, Phase I
Clinical Trial, Phase II
Journal Article
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22349044

Citation

AlFaleh, Hussam F., et al. "The Prognostic Impact of In-hospital Worsening of Renal Function in Patients With Acute Coronary Syndrome." International Journal of Cardiology, vol. 167, no. 3, 2013, pp. 866-70.
AlFaleh HF, Alsuwaida AO, Ullah A, et al. The prognostic impact of in-hospital worsening of renal function in patients with acute coronary syndrome. Int J Cardiol. 2013;167(3):866-70.
AlFaleh, H. F., Alsuwaida, A. O., Ullah, A., Hersi, A., AlHabib, K. F., AlNemer, K., AlSaif, S., Taraben, A., Kashour, T., Balghith, M. A., & Ahmed, W. H. (2013). The prognostic impact of in-hospital worsening of renal function in patients with acute coronary syndrome. International Journal of Cardiology, 167(3), 866-70. https://doi.org/10.1016/j.ijcard.2012.01.097
AlFaleh HF, et al. The Prognostic Impact of In-hospital Worsening of Renal Function in Patients With Acute Coronary Syndrome. Int J Cardiol. 2013 Aug 10;167(3):866-70. PubMed PMID: 22349044.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The prognostic impact of in-hospital worsening of renal function in patients with acute coronary syndrome. AU - AlFaleh,Hussam F, AU - Alsuwaida,Abdulkareem O, AU - Ullah,Anhar, AU - Hersi,Ahmad, AU - AlHabib,Khalid F, AU - AlNemer,Khalid, AU - AlSaif,Shukri, AU - Taraben,Amir, AU - Kashour,Tarek, AU - Balghith,Mohammed A, AU - Ahmed,Waqar H, Y1 - 2012/02/19/ PY - 2011/07/01/received PY - 2012/01/08/revised PY - 2012/01/28/accepted PY - 2012/2/22/entrez PY - 2012/2/22/pubmed PY - 2014/4/3/medline KW - Acute coronary syndrome KW - Cardiovascular outcomes KW - Worsening renal function SP - 866 EP - 70 JF - International journal of cardiology JO - Int J Cardiol VL - 167 IS - 3 N2 - BACKGROUND: Renal impairment is strongly linked to adverse cardiovascular (CV) events. Baseline renal dysfunction is a strong predictor of CV mortality and morbidity in patients admitted with acute coronary syndrome (ACS). However, the prognostic importance of worsening renal function (WRF) in these patients is not well characterized. METHODS: ACS patients enrolled in the SPACE (Saudi Project for Assessment of Coronary Events) registry who had baseline and pre-discharge serum creatinine data available were eligible for this study. WRF was defined as a 25% reduction from admission estimated glomerular filtration rate (eGFR) within 7 days of hospitalization. Baseline demographics, clinical presentation, therapies, and in-hospital outcomes were compared. RESULTS: Of the 3583 ACS patients, WRF occurred in 225 patients (6.3%), who were older, had more cardiovascular risk factors, were more likely to be female, have past vascular disease, and presented with more non-ST-segment elevation myocardial infarction than patients without WRF (39.5% vs. 32.8%; p=0.042). WRF was associated with an increased risk of in-hospital death, heart failure, cardiogenic shock, and stroke. After adjusting for potential confounders, WRF was an independent predictor of in-hospital death (adjusted odd ratio 28.02, 95% CI 13.2-60.28, p<0.0001). WRF was more predictive of mortality than baseline eGFR. CONCLUSION: These results indicate that WRF is a powerful predictor for in-hospital mortality and CV complications in ACS patients. SN - 1874-1754 UR - https://www.unboundmedicine.com/medline/citation/22349044/The_prognostic_impact_of_in_hospital_worsening_of_renal_function_in_patients_with_acute_coronary_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0167-5273(12)00130-1 DB - PRIME DP - Unbound Medicine ER -