Chronic kidney disease in acute coronary syndromes: real-world data of long-term outcomes

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Carolina Saleiro1, Luís Puga1, Diana De Campos1

  • 1Serviço de Cardiologia, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.

Future Cardiology
|April 19, 2021
PubMed

Insights

Patients with chronic kidney disease (CKD) face higher cardiovascular risks. This study found comorbidities, not kidney function, predict survival after acute coronary syndrome.

Area of Science:

  • Cardiology
  • Nephrology
  • Epidemiology

Background:

  • Patients with chronic kidney disease (CKD) exhibit elevated cardiovascular risk.
  • Acute coronary syndrome (ACS) in CKD patients requires careful prognostic evaluation.

Purpose of the Study:

  • To investigate the association between CKD severity and outcomes following ACS.
  • To identify predictors of all-cause mortality in ACS patients with varying degrees of renal function.

Main Methods:

  • Retrospective cohort study of ACS patients categorized by CKD stages (3A, 3B, 4) using CKD-EPI and MDRD formulas.
  • Primary endpoint: all-cause mortality, with a median follow-up of 32 months.
  • Multivariable analysis adjusted for clinical factors.

Main Results:

  • Decreased median survival correlated with poorer renal function in both CKD-EPI and MDRD groups (p < 0.014 and p < 0.006, respectively).
  • Adjusted analysis revealed age and pulmonary artery systolic pressure as significant predictors of decreased survival (OR > 1.07).
  • Estimated glomerular filtration rate (eGFR) was not independently associated with survival.

Conclusions:

  • Comorbidities, specifically age and pulmonary artery systolic pressure, are more strongly associated with poor outcomes post-ACS than eGFR levels.
  • CKD staging may not be the primary determinant of survival in ACS patients; focus on comorbidities is crucial.

Keywords:
acute coronary syndromechronic kidney diseaseestimated glomerular filtration rateprognosis

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