Reduced kidney function in acute coronary syndrome patients with undiagnosed diabetes or pre-diabetes

Chronic kidney disease is highly prevalent in the diabetic population and it is also associated with adverse outcomes in patients with acute coronary syndrome (ACS). However, the risk of reduced kidney function (RKF) in ACS patients with undiagnosed diabetes or pre-diabetes is yet to be clear. Herein, the present study attempts to investigate the risk for RKF in ACS patients with special reference to undiagnosed diabetes and pre-diabetes, generating possible recommendations for early intervention and management in ACS patients.

A cross-sectional design was performed to evaluate the risk for RKF in 2232 ACS patients according to glycaemic status from the China Heart Survey between June 2005 and August 2005 by using multivariate logistic regression.

The prevalence of RKF in ACS patients with normal glucose metabolism, pre-diabetes, undiagnosed diabetes and diagnosed diabetes was 11.6%, 17.7%, 16.7% and 28.8%, respectively. In multivariate analysis, apart from ACS patients with diagnosed diabetes, those with pre-diabetes (odds ratio = 1.58, 95%:1.08-2.31) and undiagnosed diabetes (odds ratio  = 1.51, 95%:1.01-2.26) also suffered from an increased risk for RKF, compared with those with normal glucose metabolism. Stratified by ACS subtypes, the associations of RKF with ACS subtypes remained statistically significant.

The increased risk of RKF was significantly associated with undiagnosed diabetes and pre-diabetes, relative to normal glucose metabolism. Screenings for RKF among ACS patients with pre-diabetes or newly diagnosed diabetes would be highly recommended.