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Chronic kidney disease in acute coronary syndromes

Giancarlo Marenzi1, Angelo Cabiati, Emilio Assanelli

  • 1Giancarlo Marenzi, Angelo Cabiati, Emilio Assanelli, Centro Cardiologico Monzino, IRCCS Department of Cardiovascular Sciences, University of Milan, 20138 Milan, Italy.

World Journal of Nephrology
|November 1, 2013
PubMed

Insights

Patients with chronic kidney disease (CKD) face worse outcomes with acute coronary syndromes (ACS). This review examines evidence on managing these complex cases, focusing on therapies and revascularization strategies.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Medicine

Background:

  • Coronary artery disease poses a significant burden in patients with chronic kidney disease (CKD).
  • CKD is prevalent in acute coronary syndrome (ACS) patients, correlating with adverse short- and long-term prognoses.
  • Managing ACS in CKD patients is challenging due to limited clinical trials and concerns about renal function and treatment toxicity.

Purpose of the Study:

  • To review the epidemiology of CKD in ACS patients.
  • To discuss the clinical and prognostic significance of CKD in ACS.
  • To address uncertainties in medical therapies and revascularization strategies for ACS patients with CKD.

Main Methods:

  • Literature review of existing evidence.
  • Analysis of epidemiological data.
  • Synthesis of clinical and prognostic information.

Main Results:

  • CKD is common in ACS patients and linked to poorer outcomes.
  • Patients with CKD are often excluded from clinical trials for ACS therapies.
  • Proven medical therapies and revascularization strategies may be underutilized in this high-risk group.

Conclusions:

  • CKD significantly impacts ACS patient outcomes.
  • Further research is needed to optimize treatment strategies for ACS patients with CKD.
  • Addressing therapeutic and revascularization uncertainties is crucial for improving care.

Keywords:
Acute coronary syndromesChronic kidney diseaseNon-ST-elevation myocardial infarctionPercutaneous coronary interventionRenal insufficiencyST-elevation myocardial infarction

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