Renal disease and acute coronary syndrome

Widimský, Petr; Rychlík, Ivan

doi:10.1136/hrt.2008.161034

Cited by 17 publications

(16 citation statements)

References 26 publications

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“…Several studies have shown that patients with CKD who undergo revascularization by PCI and stenting consistently have worse short- and long-term outcomes relative to patients without CKD [1], [2]. Many of these studies included patients who had PCI before the advent of DES.…”

Section: Discussionmentioning

confidence: 99%

“…We did not study outcomes stratified by every stage of CKD and for patients on dialysis. While it is possible that patients with stages 4 and 5 CKD may have worse outcomes relative to those of stage 3 CKD, and patients with stages 1 and 2 CKD may have worse outcomes relative to patients without CKD, our goal was to study the utility of DES in a broad group of patients with CKD that are at the greatest risk for atherosclerotic cardiovascular disease and need for revascularization, that is, patients with creatinine clearance <60 mL/min [1], [14]. Finally, we did not include data about the etiology of renal dysfunction in patients with creatinine clearance <60 mL/min.…”

Section: Discussionmentioning

confidence: 99%

“…In patients with coronary artery disease, the presence of chronic kidney disease (CKD) is strongly associated with increased mortality and an increased incidence of major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI) [1], [2], [3].…”

Section: Introductionmentioning

confidence: 99%

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Drug-Eluting Stents in Patients with Chronic Kidney Disease: A Prospective Registry Study

et al. 2010

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BackgroundChronic kidney disease (CKD) is strongly associated with adverse outcomes after percutaneous coronary intervention (PCI). There are limited data on the effectiveness of drug-eluting stents (DES) in patients with CKD.Methodology/Principal FindingsOf 3,752 consecutive patients enrolled in the Guthrie PCI Registry between 2001 and 2006, 436 patients with CKD - defined as a creatinine clearance <60 mL/min - were included in this study. Patients who received DES were compared to those who received bare metal stents (BMS). Patients were followed for a mean duration of 3 years after the index PCI to determine the prognostic impact of stent type. Study end-points were all-cause death, myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and the composite of major adverse cardiovascular events (MACE), defined as death, MI or TVR. Patients receiving DES in our study, by virtue of physician selection, had more stable coronary artery disease and had lower baseline risk of thrombotic or restenotic events. Kaplan-Meier estimates of proportions of patients reaching the end-points were significantly lower for DES vs. BMS for all-cause death (p = 0.0008), TVR (p = 0.029) and MACE (p = 0.0015), but not MI (p = 0.945) or ST (p = 0.88). Multivariable analysis with propensity adjustment demonstrated that DES implantation was an independent predictor of lower rates of all-cause death (hazard ratio [HR] 0.48, 95% confidence interval [CI] 0.25–0.92), TVR (HR 0.50, 95% CI 0.27–0.94) and MACE (HR 0.62, 95% CI 0.41–0.94).ConclusionsIn a contemporary PCI registry, selective use of DES in patients with CKD was safe and effective in the long term, with lower risk of all-cause death, TVR and MACE and similar risk of MI and ST as compared with BMS. The mortality benefit may be a result of selection bias and residual confounding, or represent a true finding; a hypothesis that warrants clarification by randomized clinical trials.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Drug-Eluting Stents in Patients with Chronic Kidney Disease: A Prospective Registry Study

et al. 2010

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“…An international registry showed that the existence of CKD was at least 40% in patients with ACS (8,9). It was shown that eGFR can be considered an independent risk factor of ACS (10,11), and that decreased renal function is an independent predictor of ACS in patients with fatal and non-fatal cardiovascular events, whereby abnormal renal dysfunction after admission is indicative of short-term and long-term prognosis of patients (12). This study also found that when renal dysfunction was defined as eGFR < 90 mL·min -1· 1.73 m -2 , 72.3% of patients with ACS had renal dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Analysis of the Clinical Characteristics of Patients with Acute Coronary Syndrome in Different States of Renal Function

Lh¹,

Lj²,

Zt³

et al. 2015

West Indian Med J

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This study aimed to investigate the effect of chronic kidney dysfunction (CKD) RESUMEN Este estudio se propuso investigar el efecto de la disfunción renal crónica (DRC) sobre las característi-cas clínicas de los pacientes con síndrome coronario agudo (SCA), y el grado de estenosis arterial coronaria. El estudio comprendió 368 pacientes con SCA sometidos a angiografía coronaria. La glucosa en sangre, la hemoglobina glicosilada (HbA1c), el colesterol total, los triglicéridos (TG), el colesterol de lipoproteína de baja densidad (LDL-C), el colesterol de lipoproteínas de alta densidad (HDL-C), el ácido úrico (AU), y la creatinina sérica fueron examinados de manera aleatoria, evaluándose la gravedad de las lesiones de la arteria coronaria mediante la puntuación de Gensini. Los pacientes fueron divididos en tres grupos según el índice de filtración glomerular estimado: función renal normal (n = 102), insuficiencia renal leve (n = 198), y disfunción renal moderada a severa (n = 68

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“…Several studies have shown that patients with CKD who undergo revascularization with PCI and stenting consistently have worse short- and long-term outcomes relative to patients without CKD [8]. Many of these studies included patients who had PCI before the advent of DES.…”

Section: Bms or Desmentioning

confidence: 99%

The Optimal Revascularization Therapy for Coronary Artery Disease Patients with Chronic Kidney Disease

Park

2012

Korean J Intern Med

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Renal disease and acute coronary syndrome

Cited by 17 publications

References 26 publications

Drug-Eluting Stents in Patients with Chronic Kidney Disease: A Prospective Registry Study

Drug-Eluting Stents in Patients with Chronic Kidney Disease: A Prospective Registry Study

Analysis of the Clinical Characteristics of Patients with Acute Coronary Syndrome in Different States of Renal Function

The Optimal Revascularization Therapy for Coronary Artery Disease Patients with Chronic Kidney Disease

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