Poor awareness of chronic kidney disease in patients with acute coronary syndrome--challenge for cardiologists and nephrologists

Babińska, Magdalena; Chudek, Jerzy; Ignacy, Witold; Owczarek, Aleksander; Prochaczek, F; Wicek, Andrzej

doi:10.1093/ndt/gfp076

Cited by 2 publications

(1 citation statement)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although there is no particular reason not to treat IGFR patients just like patients without renal dysfunction, physicians prescribed fewer guideline-recommended treatments even in the absence of contraindications [18]. Furthermore, poor awareness of impaired renal function and its risk in patients with ACS is a big challenge both for the physicians and patients [19]. As shown in our study, those with IGFR had more comorbidities but received fewer guideline-recommended medications.…”

Section: Discussionmentioning

confidence: 84%

Impact of impaired glomerular filtration rate and revascularization strategy on one-year cardiovascular events in acute coronary syndrome: data from Taiwan acute coronary syndrome full spectrum registry

et al. 2014

View full text Add to dashboard Cite

BackgroundThe optimal revascularization strategy for patients with impaired glomerular filtration rate (IGFR) has not been established in acute coronary syndrome (ACS). We investigated the prognosis and impact of IGFR and invasive strategy on the cardiovascular outcomes in the ACS population.MethodsIn a Taiwan national-wide registry, 3093 ACS patients were enrolled. The invasive strategy was defined as patients with ST-elevation ACS (STE-ACS) undergoing primary angioplasty or fibrinolysis or coronary angiography with intent to revascularization performed within 72 hours of symptom onset in non-ST-elevation ACS (NSTE-ACS). IGFR was defined as an estimated GFR of less than 60 ml/min per 1.73 m2. Primary endpoint was a composite of death, non-fatal myocardial infarction or stroke at one year.ResultsPatients with IGFR (n = 1226) had more comorbidities but received less evidence-based medications during admission than those without IGFR (n = 1867). The primary endpoint-free survival rate is lower in the IGFR patients, in the whole, STE-ACS and NSTE-ACS population (all log-rank tests p < 0.01). Cox regression analysis revealed IGFR subjects had higher primary endpoint after adjusting by age, sex, medication at discharge and traditional risk factors (all p < 0.01). Kaplan–Meier curves showed IGFR patients without invasive strategy had the worst outcome in the STE-ACS and NSTE-ACS population (both p < 0.01). The invasive strategies, either with early angiography only or angioplasty, were associated with reduced primary endpoints among IGFR patients in the NSTE-ACS population (both p ≦ 0.024).ConclusionsIGFR patients suffering from ACS had poor prognosis and an invasive strategy could improve cardiovascular outcome in the NSTE-ACS population.

show abstract

Section: Discussionmentioning

confidence: 84%