Impact of renal dysfunction on long-term outcomes of elderly patients with acute coronary syndrome: a longitudinal, prospective observational study

BMC Nephrology

Yang Li²  Yu Wang²  Pu Chen¹  Muyang Yan²  Qiao Xue²  Lei Gao²  Yuqi Liu² 

[1] Kidney Department, Chinese PLA General Hospital, Beijing 100853, China;Institute of Geriatric Cardiology, Chinese PLA General Hospital, Beijing 100853, China

关键词: Elderly;    MACE;    Renal dysfunction;    Glomerular filtration rate;    Acute coronary syndrome;   

Others  :  1082684
DOI  :  10.1186/1471-2369-15-78

 received in 2012-10-01, accepted in 2014-03-12,  发布年份 2014

【 摘 要 】

Background

This study investigated the impact of renal dysfunction (RD) on long-term outcomes in elderly patients with acute coronary syndrome (ACS), and evaluated prognostic factors in elderly patients with ACS and RD.

Methods

This longitudinal prospective study included 184 consecutive patients who were admitted with ACS between January 2009 and January 2010 and also had RD. Patients were divided into five groups according to their estimated glomerular filtration rate (eGFR): 1) eGFR ≥ 90 mL/min/1.73 m² with evidence of kidney damage, 2) 60 ≤ eGFR < 90 mL/min/1.73 m², 3) 30 ≤ eGFR < 60 mL/min/1.73 m², 4) 15 ≤ eGFR < 30 mL/min/1.73 m², and 5) eGFR < 15 mL/min/1.73 m². The primary endpoints were death and complications during hospitalization. The secondary endpoint was any major adverse cardiac event (MACE) during follow-up.

Results

The mean follow-up period was 502.2 ± 203.6 days. The mean patient age was 73.7 ± 9.4 years, and 61.4% of the patients were men. Severe RD (eGFR < 30 mL/min/1.73 m²) was an independent predictor of MACE. Severe RD was associated with a low hemoglobin level, low left ventricular ejection fraction, and high levels of high-sensitivity C-reactive protein, N-terminal pro-B-type natriuretic peptide, and cystatin C. Survival was significantly poorer in patients with severe RD than in patients with mild RD.

Conclusions

Among patients with ACS, severe RD was associated with advanced age, diabetes, hypertension, and cardiac dysfunction. Severe RD was an independent risk factor for MACE, and was associated with poor prognosis.

【 授权许可】

   
2014 Liu et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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