Temporal Trends in Invasive Management and In-Hospital Mortality of Patients With Non-ST Elevation Acute Coronary Syndromes and Chronic Kidney Disease

Author:

De Luca Leonardo1ORCID,Di Pasquale Giuseppe2,Gonzini Lucio3,Uguccioni Massimo1,Olivari Zoran4,Casella Gianni2,Boccanelli Alessandro5,De Servi Stefano6,Urbinati Stefano7,Colivicchi Furio8,Gabrielli Domenico9,Savonitto Stefano10ORCID

Affiliation:

1. Department of Cardiosciences, A.O. San Camillo-Forlanini, Roma, Italy

2. Department of Cardiology, Maggiore Hospital, Bologna, Italy

3. ANMCO Research Center, Florence, Italy

4. Division of Cardiology, Ospedale Cà Foncello, Treviso, Italy

5. Department of Cardiovascular Diseases, S. Giovanni-Addolorata Hospital, Roma, Italy

6. University of Pavia, Pavia, Italy

7. Division of Cardiology, Ospedale Bellaria, Bologna, Italy

8. Division of Cardiology, S. Filippo Neri Hospital, Roma, Italy

9. Division of Cardiology, Augusto Murri Hospital, Fermo, Italy

10. Division of Cardiology, Ospedale A. Manzoni, Lecco, Italy

Abstract

We analyzed data from 4 nationwide prospective registries of consecutive patients with acute coronary syndromes (ACS) admitted to the Italian Intensive Cardiac Care Unit network between 2005 and 2014. Out of 26 315 patients with ACS enrolled, 13 073 (49.7%) presented a diagnosis of non-ST elevation (NSTE)-ACS and had creatinine levels available at hospital admission: 1207 (9.2%) had severe chronic kidney disease (CKD) (estimated glomerular filtration rate [eGFR] <30), 3803 (29.1%) mild to moderate CKD (eGFR 31-59), and 8063 (61.7%) no CKD (eGFR > 60 mL/min/1.73 m2). Patients with severe CKD had worse clinical characteristics compared with those with mild-moderate or no kidney dysfunction, including all the key predictors of mortality ( P < .0001) which became worse over time (all P < .0001). Over the decade of observation, a significant increase in percutaneous coronary intervention rates was observed in patients without CKD ( P for trend = .0001), but not in those with any level of CKD. After corrections for significant mortality predictors, severe CKD (odds ratio, OR: 5.49; 95% CI: 3.24-9.29; P < .0001) and mild-moderate CKD (OR: 2.33; 95% CI: 1.52-3.59; P < .0001) remained strongly associated with higher in-hospital mortality. The clinical characteristics of patients with NSTE-ACS and CKD remain challenging and their mortality rate is still higher compared with patients without CKD.

Funder

Sanofi-Aventis and Bristol-Myers Squibb

BLITZ-4

glaxosmithkline

Heart Care Foundation

Publisher

SAGE Publications

Subject

Cardiology and Cardiovascular Medicine

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3