Evaluation of short-term outcomes of impaired creatinine clearance in patients with acute coronary syndromes: A prospective cohort study at tertiary care center

Abstract

Background: Chronic kidney disease is commonly seen in patients presenting with acute coronary syndrome (ACS), and it has been shown to have poor outcomes. We evaluated the prevalence of impaired creatinine clearance and its impact on short-term clinical outcomes in patients admitted with ACS without prior documented chronic renal disease. Materials and Methods: The present study was an observational, prospective cohort study conducted at a tertiary care center in North India. In patients admitted with a diagnosis of ACS, glomerular filtration rate was estimated (eGFR) by the Modification of Diet in Renal Disease Study Equation. Patients with eGFR 90 mL/min comprised control group. The study group was further categorized into three subgroups on the basis of eGFR (1.5 mg/dl) enhances the ability to predict death by 33% and MACE events by 143%. The OR for predicting death with various cutoff of eGFR was as follows: eGFR <30 ml/min – 3.61, eGFR: 30–60 ml/min – 4.2 and eGFR: 60–90 ml/min – 0.5. Conclusion: Almost one-third of the patients presenting with ACS have impaired creatinine clearance. Patients with impaired creatinine clearance have worse outcome in hospital vis-a-vis their contemporary groups with normal eGFR. eGFR is a better risk assessment parameter than SCr for predicting MACE and overall mortality in ACS patients.

Keywords

• Acute coronary syndrome
• estimated glomerular filtration rate
• impaired renal function
• major adverse cardiac event
• serum creatinine