Prognostic Value of Chronic Kidney Disease in Acute Coronary Syndrome Patients Treated with Percutaneous Coronary Intervention

Abstract

<p><strong>Objective:</strong>Impact of renal impairment (RI) on short&long term outcome of percutaneous coronary intervention (PCI) in patients with ACS.</p><p><strong>Methods:</strong> 427 patients with ACS, treated with PCI .They were classified into 4 groups (normal , mild, moderate and severe renal impairment) based on creatinine clearance (eCrCl).MACE including death, new myocardial infarction (MI) and target vessel revascularization (TVR) were recorded during early (30 days) and late for average 49months.</p><p><strong>Results:</strong>Patients with severe RI had higher number of vessels affected (p 0.023), lower grade of TIMI flow(p0.029), lower percent dilatation of culprit lesion( p<0.001), less frequent use of GPIIb/IIIa inhibitors(p0.002) and more frequent need for TVR(p0.03). eCrCl had positive correlation with EF and percent dilatation of stenotic lesion (p,0.001)and negative correlation with number of vessels & late MACE(p0.001).Patients with severe RI had increase in frequency of lateMACE compared to other groups(p0.001).TypeC lesions were more common in patients with advanced RI(p0.03).MACE free survival showed significant decline matching the decline in eCrCl among study groups.</p><p><strong>Conclusion:</strong> PCI outcome in patients with severe RI was suboptimal.They had increased riskof TVR within one month and increased riskof MI,death and total MACE on the long term.</p>

Renal Dysfunction in Patients With Acute Coronary Syndrome (Acs) at a Tertiary Care Hospital

“…[5][6][7][8] Renal dysfunction is an independent and important risk factor for cardiac diseases and is also a strong predictor of adverse outcomes in patients with various cardiovascular conditions including ACS, even if it is mild. [9][10][11][12][13][14][15] The adverse out come in MI patients associated with renal 13 Glomerular Filtration Rate (GFR) estimation is an important and independent predictor of in hospital and outpatient mortality in patients with ACS. 16 In Valsartan acute MI trial (VALIANT), 14527 patients of MI were studied and it has been highlighted in this study that even mild renal dysfunction, assessed on the basis of estimated GFR, is to be considered as major risk factor for cardiovascular complications in patients of MI.…”