Background and aim:

Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular outcomes after non-ST elevation acute coronary syndrome (NSTEACS). However, the information available on this specific population, is scarce. We evaluate the impact of CKD on long-term prognosis in patients with NSTEACS managed with invasive strategy.

Methods:

We conduct a prospective registry of patients with NSTEACS and coronary angiography. CKD was defined as a glomerular filtration rate <60 ml/min/1,73 m2. The composite primary end-point was cardiac death and non fatal cardiovascular readmission. We estimated the cumulative probability and hazard rate (HR) of combined primary end-point at 3-years according to the presence or absence of CKD.

Results:

We included 248 p with mean age of 66.9 years, 25% women. CKD was present at baseline in 67 patients (27%). Patients with CKD were older (74.9 vs. 63.9 years; P < .0001) with more prevalence of hypertension (89.6 vs. 66.3%; P < .0001), diabetes (53.7 vs. 35.9%; P = .011), history of heart failure (13.4 vs. 3.9%; P = .006) and anemia (47.8 vs. 16%; P < .0001). No differences in the extent of coronary artery disease. CKD was associated with higher cumulative probability (49.3 vs. 28.2%; log-rank P = .001) and HR of the primary combined end-point (HR: 1.94; CI95%: 1.12-3.27; P = .012). CKD was an independent predictor of adverse cardiovascular outcomes at 3-years (HR: 1.66; CI95%: 1.05-2.61; P = .03).

Conclusions:

In NSTEACS patients treated with invasive strategie CKD is associated independently with an increased risk of adverse cardiovascular outcomes at 3 years.

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