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Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome

Raquel Pimienta González1, Patricia Couto Comba1, Marcos Rodríguez Esteban1

  • 1Servicio de Cardiología. Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain.

Plos One
|December 2, 2016
PubMed

Insights

Cardiorenal syndrome subtype 1 (CRS1) significantly increases cardiovascular mortality risk in acute coronary syndrome (ACS) patients, exceeding the combined risks of its components. CRS1 severity also worsens prognosis, highlighting its critical impact.

Area of Science:

  • Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • Cardiorenal syndrome subtype 1 (CRS1) is a critical condition in patients hospitalized for acute coronary syndrome (ACS).
  • Understanding the independent and combined risks of CRS1 components (acute heart failure and acute kidney injury) is crucial for patient outcomes.

Purpose of the Study:

  • To evaluate if CRS1 poses a greater cardiovascular mortality risk than the sum of its individual components in ACS patients.
  • To determine the predictive value of CRS1 for mortality and readmission.
  • To assess the impact of CRS1 severity on patient prognosis.

Main Methods:

  • A 1-year follow-up study involving 1912 incident ACS cases post-discharge.
  • Cox regression models were employed to analyze time-to-event data, including in-hospital death and post-discharge events.

Main Results:

  • CRS1 accounted for 56.6% of all mortality among ACS patients.
  • The positive predictive value of CRS1 was 29.6% for in-hospital death and 51.4% for post-discharge events.
  • CRS1 conferred a significantly higher risk of in-hospital death (RR=18.3) compared to the sum of risks from acute heart failure (RR=7.6) or acute kidney injury (RR=2.8).
  • Increased CRS1 severity correlated with higher event risk, with the highest severity level showing an RR of 10.6 for in-hospital death.

Conclusions:

  • The mortality risk associated with CRS1 in ACS patients is substantially greater than the additive risks of its components.
  • CRS1 severity is directly linked to a worsening prognosis.
  • CRS1 is a major contributor to mortality in ACS patients, with significant predictive value for adverse outcomes.
Abstract

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