Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.23/779
Título: Prognostic value of in-hospital worsening of renal function in patients with acute coronary syndrome
Autor: Gaspar, A
Nabais, S
Torres, M
Rocha, S
Brandão, A
Azevedo, P
Álvares-Pereira, M
Correia, A
Palavras-chave: Doenças do Rim
Síndrome Coronária Aguda
Data: 2008
Citação: ESC Congress 2008. 30 Aug 2008 - 03 Sep 2008 , Munich - Germany
Resumo: Purpose: The association between a history of renal insufficiency and poor outcome in patients with acute coronary syndrome (ACS) is well known. However, little information is available about in-hospital worsening of renal function. Our goal was to determine the prognostic impact of in-hospital worsening of renal function in patients with ACS. Methods: A total of 1228 patients consecutively admitted with ACS from January 2004 to March 2007 were reviewed. Patients deceased in hospital and patients with < 2 analysis and/or without creatinine value on admission were excluded. The selected patients were classified into 2 groups. Group I included patients with an increase in creatinine <0,5 mg/dL. Group II included patients with an increase in creatinine ≥ 0,5 mg/dL. The primary endpoint was 6-month mortality from any cause. Results: Of the 1134 patients finally selected, 1028 belonged to group I and 106 to group II. Patients of group II were older (74,08±8,8 vs 63,2±12,9; p <0,001), more frequently women (39,6% vs 26,1%; p= 0,003) and more often had diabetes mellitus (42,5% vs 25,7%; p=0,001), arterial hypertension (77,4% vs 62,0%; p=0,001) and renal insufficiency (63,5% vs 19,8%; p <0,001). Patients of group II had higher 6-month mortality compared with patients in group I (24,5% vs 5,0%; p <0,001). After adjustment for known risk factors by multivariate analysis (age, history of renal insufficiency, diabetes mellitus, creatinine value on admission, history of myocardial infarction, Killip class on admission, heart rate on admission, systolic blood pressure on admission and left ventricular systolic dysfunction), an increase in creatinine remained a independent predictor of 6-month mortality (OR=2,45; 95% confidence interval 1,42 to 4,24; p=0,0013). Conclusions: In-hospital worsening of renal function is associated with increased 6-month mortality in patients with ACS.
Peer review: yes
URI: http://hdl.handle.net/10400.23/779
Aparece nas colecções:HB - CAR - Comunicações e Conferências

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