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

González, Raquel Pimienta; Comba, Patricia Couto; Esteban, Marcos Rodríguez; Sánchez, José Juan Alemán; Hernández-Afonso, Julio; Pérez, María del Cristo Rodríguez; Marcelino-Rodríguez, Itahisa; Díaz, Buenaventura Brito; Elosúa, Roberto; León, Antonio Cabrera de

doi:10.1371/journal.pone.0167166

Cited by 16 publications

(8 citation statements)

References 29 publications

(33 reference statements)

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“…Acute Kidney Injury (AKI) is a common complication of acute coronary syndromes, and its ultimate expression is the cardiorenal syndrome (CRS) type 1, defined “as an acute worsening of heart function leading to AKI or dysfunction” that is a complication of “acute heart failure (AHF) and/or acute coronary syndrome (ACS)”, associated with a high risk mortality and longer hospital stay [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Ortega-Hernandez

Springall

Sánchez‐Muñoz

et al. 2017

BMC Cardiovasc Disord

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BackgroundAcute Kidney Injury (AKI), a common complication of acute coronary syndromes (ACS), is associated with higher mortality and longer hospital stays. The role of cytokines and other mediators is unknown in AKI induced by an ACS (ACS-AKI), leading to several unanswered questions. The worsening of renal function is usually seen as a dichotomous phenomenon instead of a dynamic change, so evaluating changes of the renal function in time may provide valuable information in the ACS-AKI setting. The aim of this study was to explore inflammatory factors associated to de novo kidney injury induced by de novo cardiac injury secondary to ACS.MethodsOne hundred four consecutive patients with ACS were initially included on the time of admission to the Coronary Unit of the Instituto Nacional de Cardiología in Mexico City, from February to May 2016, before any invasive procedure, imaging study, diuretic or anti-platelet therapy. White blood count, hemoglobin, NT-ProBNP, troponin I, C-reactive protein, albumin, glucose, Na+, K+, blood urea nitrogen (BUN), total cholesterol, HDL, LDL, triglycerides, creatinine (Cr), endothelin-1 (ET-1), leukotriene-B4, matrix metalloproteinase-2 and -9, tissue inhibitor of metalloproteinases-1, resolvin-D1 (RvD1), lipoxin-A4 (LXA4), interleukin-1β, −6, −8, and −10 were measured. We finally enrolled 78 patients, and subsequently we identified 15 patients with ACS-AKI. Correlations were obtained by a Spearman rank test. Low-rank regression, splines regressions, and also protein–protein/chemical interactions and pathways analyses networks were performed.ResultsPositive correlations of ΔCr were found with BUN, admission Cr, GRACE score, IL-1β, IL-6, NT-ProBNP and age, and negative correlations with systolic blood pressure, mean-BP, diastolic-BP and LxA4. In the regression analyses IL-10 and RvD1 had positive non-linear associations with ΔCr. ET-1 had also a positive association. Significant non-linear associations were seen with NT-proBNP, admission Cr, BUN, Na+, K+, WBC, age, body mass index, GRACE, SBP, mean-BP and Hb.ConclusionInflammation and its components play an important role in the worsening of renal function in ACS. IL-10, ET-1, IL-1β, TnI, RvD1 and LxA4 represent mediators that might be associated with ACS-AKI. IL-6, ET-1, NT-ProBNP might represent crossroads for several physiopathological pathways involved in “de novo cardiac injury leading to de novo kidney injury”.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-017-0640-0) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Ortega-Hernandez

Springall

Sánchez‐Muñoz

et al. 2017

BMC Cardiovasc Disord

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“…Comparison of these biomarkers can help in the application and selection of specific biomarkers in different clinical situations. Compared with NT-proBNP and cTnT, cystatin C has an additional ability to assess prognosis and stratify risk in patients with HF [ 72 ]. Compared with IL-18 and cystatin C, NGAL has a superior ability to predict the duration of AKI, renal replacement therapy, length of hospital stay, and mortality rates.…”

Section: Strength/weaknessmentioning

confidence: 99%

Biomarkers in Cardiorenal Syndromes

Zhao

Luo

2018

BioMed Research International

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There is a consensus that cardiorenal syndromes (CRS) are defined as the disorders of heart and kidney where acute or chronic dysfunction in one organ may induce acute or chronic dysfunction in another. Patients with CRS have increased hospitalization and mortality rates, and thus their identification is of great implication. Biomarkers are not only predictive in heart failure or renal diseases, but also useful in identifying cardiac dysfunction in renal diseases and renal injury in heart failure. Thus, they may be applied in order to identify patients with CRS and even assess prognosis and guide therapy in these patients. However, studies on biomarkers have just begun in CRS. Future studies are essential to observe current biomarkers and find novel biomarkers in CRS so as to improve diagnosis, therapy, and prognosis of CRS.

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“…Therefore, the identification of patients with CRS has a great implication in terms of prognosis since the coexistence of both heart and renal impairment may worsen the prognosis in these patients. Indeed, CRS is characterized by a high mortality rate and by a high in-hospital mortality rate, particularly in type 1 CRS [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

Gallo

Lanza

Savoia

2023

IJMS

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Cardiorenal syndrome consists in the coexistence of acute or chronic dysfunction of heart and kidneys resulting in a cascade of feedback mechanisms and causing damage to both organs associated with high morbidity and mortality. In the last few years, different biomarkers have been investigated with the aim to achieve an early and accurate diagnosis of cardiorenal syndrome, to provide a prognostic role and to guide the development of targeted pharmacological and non-pharmacological therapies. In such a context, sodium-glucose cotransporter 2 (SGLT2) inhibitors, recommended as the first-line choice in the management of heart failure, might represent a promising strategy in the management of cardiorenal syndrome due to their efficacy in reducing both cardiac and renal outcomes. In this review, we will discuss the current knowledge on the pathophysiology of cardiorenal syndrome in adults, as well as the utility of biomarkers in cardiac and kidney dysfunction and potential insights into novel therapeutics.

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

Cited by 16 publications

References 29 publications

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Acute coronary syndrome and acute kidney injury: role of inflammation in worsening renal function

Biomarkers in Cardiorenal Syndromes

New Insight in Cardiorenal Syndrome: From Biomarkers to Therapy

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