Qi Lingyao, Liu Hanxiong, Cheng Lianchao, Cui Caiyan, Chen Xu, Yang Siqi, Cai Lin
Department of Cardiology, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, Sichuan, People's Republic of China.
Int J Gen Med. 2021 Nov 26;14:8919-8927. doi: 10.2147/IJGM.S334014. eCollection 2021.
Chronic kidney disease (CKD) is common in patients admitted with acute coronary syndrome (ACS), and it is associated with poor outcomes. However, data are limited. Hence, we examined the long-term prognostic significance of estimated glomerular filtration rate (eGFR) among Chinese patients hospitalized with ACS.
This is a multicenter, observational study that included 1860 ACS patients enrolled between March 2014 and June 2019 from 11 hospitals in Chengdu. CKD-EPI equation was used to calculate the baseline eGFR. Patients were divided into three groups: eGFR ≥ 90 mL/min (normal renal function), eGFR 60 to <90 mL/min (mild impaired renal function), and eGFR < 60 mL/min (moderate or severe renal dysfunction). The endpoint was all-cause death during follow-up.
At baseline, 714 patients had normal renal function, while 746 patients had mild impaired renal function, and 400 patients had moderate or severe renal dysfunction. In the follow-up of 15 months (10 months, 22 months), 261 (14.0%) patients died;, 139 (34.8%) in the moderate or severe renal dysfunction group, 94 (12.6%) in the mild impaired renal function group, and 28 (3.9%) in the normal renal function group (log-rank p-value from Kaplan-Meier analysis <0.001). In multivariable Cox Proportional hazard analysis, age, systolic blood pressure (SBP), heart rate, eGFR, ST-elevation myocardial infarction (STEMI), and percutaneous coronary intervention (PCI) were independent predictors of all-cause death.
In this study, among Chinese patients with ACS, renal insufficiency was associated with unfavorable long-term prognosis. Age, SBP, heart rate, eGFR, STEMI, and PCI could identify those at risk.
慢性肾脏病（CKD）在急性冠脉综合征（ACS）住院患者中很常见，且与不良预后相关。然而，相关数据有限。因此，我们研究了估算肾小球滤过率（eGFR）在中国ACS住院患者中的长期预后意义。
这是一项多中心观察性研究，纳入了2014年3月至2019年6月期间来自成都11家医院的1860例ACS患者。采用CKD-EPI方程计算基线eGFR。患者分为三组：eGFR≥90 mL/分钟（肾功能正常）、eGFR 60至<90 mL/分钟（轻度肾功能受损）、eGFR<60 mL/分钟（中度或重度肾功能不全）。终点为随访期间的全因死亡。
基线时，714例患者肾功能正常，746例患者轻度肾功能受损，400例患者中度或重度肾功能不全。在15个月（10个月，22个月）的随访中，261例（14.0%）患者死亡；中度或重度肾功能不全组139例（34.8%），轻度肾功能受损组94例（12.6%），肾功能正常组28例（3.9%）（Kaplan-Meier分析的对数秩p值<0.001）。在多变量Cox比例风险分析中，年龄、收缩压（SBP）、心率、eGFR、ST段抬高型心肌梗死（STEMI）和经皮冠状动脉介入治疗（PCI）是全因死亡的独立预测因素。
在本研究中，中国ACS患者中，肾功能不全与不良的长期预后相关。年龄、SBP、心率、eGFR、STEMI和PCI可识别有风险的患者。
