Renal dysfunction as an independent predictor of total mortality after acute coronary syndrome: the Thai ACS Registry

Khorawit Sooklim, Suphot Srimahachota, Smonporn Boonyaratavej, Rungsrit Kanjanavanit, Napa Siriviwattanakul, Chumpol Piamsomboon, Rangson Ratanaprakarn
Journal of the Medical Association of Thailand 2007, 90 Suppl 1: 32-40

BACKGROUND: Renal insufficiency in the acute coronary syndrome (ACS) is associated with poor cardiac outcome. In Asian populations, there are no data available for these associations.

MATERIAL AND METHOD: Data was from the Thai ACS registry, only a new case of ACS. Clinical characteristics, treatment strategies, in-hospital mortality and 1-year mortality were compared for patients with normal or mild renal dysfunction (estimated glomerular filtration rate [eGFR]> 60 ml/minute/1.73 m2, n = 809 [44.5%]), moderate renal dysfunction (eGFR 30-60 ml/minute/1.73 m2, n = 706 [38.9%]), and severe renal dysfunction (eGFR < 30 ml/minute/1.73 m2, n = 301 [16.6%]).

RESULTS: Of the 1,816patients with mean follow-up 10.8 months, the mean age was 65 years, and 59.2 percent of the groups were male. Patients with severe renal dysfunction were significantly older, less likely to be male (45.2%, p < 0.001) and had a greater prevalence of diabetes (63.1%, p < 0.001) and hypertension (85.4%, p < 0.001). In-hospital and 1-year mortality were 13.5% and 22.5% respectively. According to discharge diagnosis, unadjusted hazard ratios for overall in-hospital mortality was statistically significant only in ST elevation MI subgroup, hazard ratio was 2.73 (95% CI, 1.72 to 4.34) and 6.27 (95% CI, 3.78 to 10.4) for moderate and severe renal dysfunction group, respectively. The risk of death for all types of ACS at 1-year follow up increased when eGFR decreased below 60 ml/minute/1.73 m2, the adjusted hazard ratio was 1.66 (95% CI,1.22 to 2.23) and 1.91 (95% CI, 1.34 to 2.72) for moderate and severe renal dysfunction group, respectively.

CONCLUSION: From Thai ACS registry, renal dysfunction at presentation is an independent predictor for the overall 1-year mortality and appeared to associate with an increase in hospital mortality in the subsets with STEMI

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"