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. 2012 Oct 6;1(5):134–145. doi: 10.5527/wjn.v1.i5.134

Table 1.

Most important studies on the in-hospital and long-term prognostic relevance of chronic kidney disease in acute coronary syndromes

Source Year Kind of ACS No. of patients Evaluated mortality CKD definition and severity Mortality rate in CKD patients (%) Mortality rate in no-CKD patients (%) Comment
Herzog et al[3] 1998 STEMI 34 189 In-hospital Patients in dialysis 26 - Included pts with a first STEMI after dialysis initiation
1-yr 59
2-yr 73
3-yr 81
5-yr 90
10-yr 97
Chertow et al[4] 2000 STEMI 640 30-d (1-yr) Patients in dialysis 20 (53) - Only 7% of pts were treated with PCI and 5% with CABG
McCullough et al[20] 2000 STEMI/NSTEMI 9544 Mean follow-up: 27.1 mo CrCl > 81.5 mL/min 30.5 14.6 -
81.5-63.1 mL/min 54.5 22.7
63.1-46.2 mL/min 65
< 46.2 mL/min
Dialysis
Beattie et al[5] 2001 STEMI 1724 In-hospital CrCl > 81 mL/min OR 3.88 OR 1 Age- and sex-adjusted risks for in-hospital death
80-63 mL/min OR 8.76 OR 2.45
62-46 mL/min OR 5.43
< 46 mL/min
HD
Wright et al[6] 2002 STEMI 3106 In-hospital ClCl > 75 mL/min 6 2 -
75-51 mL/min 14
50-35 mL/min 21
< 35 mL/min 30
HD
Shlipak et al[7] 2002 STEMI 130 099 1-yr sCr < 1.5 mg/dL 46 24 Included pts with > 65 yr
1.5-2.4 mg/dL 66
2.5-3.9 mg/dL
Sorensen et al[22] 2002 STEMI 6252 6-yr CrCl > 85 mL/min 62 22.5 -
85-71 mL/min 83 32
70-56 mL/min 46
55-41 mL/min
< 40 mL/min
Santopinto et al[8] 2003 STEMI 4716 In-hospital CrCl > 60 mL/min 8.1 2.1 -
30-60 mL/min 18.1
< 30 mL/min
Santopinto et al[8] 2003 NSTEMI/UA 7058 In-hospital CrCl > 60 mL/min 3.8 0.9
30-60 mL/min 8.5
< 30 mL/min
Sadeghi et al[34] 2003 STEMI 2082 30-d (1 yr) CrCl < 60 mL/min 7.5 (12.7) 0.8 (7.5) Primary PCI Excluded pts with sCr > 2 mg/dL or CS
Hobbach et al[38] 2003 STEMI 352 30-d (6-mo) sCr > 1.2-2.8 mg/dL 16 (19.5) 3.4 (4.5) Included pts treated with systemic thrombolysis
Berger et al[43] 2003 STEMI 146 765 30-d Dialysis vs no dialysis patients 29 18.3 (no dialysis) Included pts with > 65 yr
Freeman et al[61] 2003 STEMI/NSTEMI 889 In-hospital sCr > 1.5 mg/dL 8.1 2.6 -
Anavekar et al[23] 2004 STEMI 14 527 3-yr eGFR > 75 mL/min per 1.73 m2 28.9 14.1 Included pts with HF and/or LV systolic dysfunction
74.9-60 mL/min per 1.73 m2 45.5 20.5
59.9-45 mL/min per 1.73 m2
< 45 mL/min per 1.73 m2
Gibson et al[11] 2004 NSTEMI/UA 13 307 30-d (6-mo) eGFR > 90 mL/min per 1.73 m2 2.1 (3.8) 1.3 (2.5) -
89-60 mL/min per 1.73 m2 5 (9.5)
< 60 mL/min per 1.73 m2
Masoudi et al[12] 2004 STEMI/NSTEMI/UA 2706 7-mo eGFR > 90 mL/min per 1.73 m2 15 3 -
89-60 mL/min per 1.73 m2 39 6
59-30 mL/min per 1.73 m2
< 30 mL/min per 1.73 m2
Mueller et al[29] 2004 NSTEMI/UA 1400 In-hospital (3-yr) eGFR > 130 mL/min per 1.73 m2 5.1 (23.2) 0 (7.4) Included pts with PCI performed within 24 h
129-90 mL/min per 1.73 m2 0.4 (4.5)
89-60 mL/min per 1.73 m2 2.6 (8.1)
< 60 mL/min per 1.73 m2
Dumaine et al[66] 2004 ACS 496 In-hospital CrCl < 60 mL/min 4.8 0.9 -
Goldberg et al[73] 2005 STEMI 1038 In-hospital (1-yr) eGFR > 90 mL/min per 1.73 m2 19.9 (29.9) 4.7 (6.7) -
89-60 mL/min per 1.73 m2 6.3 (10)
< 60 mL/min per 1.73 m2
Han et al[74] 2006 NSTEMI/ UA 45 343 In-hospital sCr > 2.0 mg/dL or dialysis 9 3.6 -
Marenzi et al[40] 2007 STEMI 467 In-hospital CrCl < 60 mL/min 8.9 3.7 Primary PCI
Fox et al[57] 2007 STEMI 20 479 30-d CrCl > 90 mL/min 15.30 2.6 Thrombolysis Excluded pts with sCr > 2.5 (men) and > 2.0 (women)
90-61 mL/min 31.10 7.1
60-30 mL/min
< 30 mL/min
Pitsavos et al[75] 2007 STEMI/NSTEMI 2172 In-hospital CrCl > 60 mL/min 7 2 -
60-30 mL/min 16
< 30 mL/min
Inrig et al[76] 2008 ACS 9190 1-yr eGFR > 90 mL/min per 1.73 m2 6 1.7 -
90-75 mL/min per 1.73 m2 5.7 2
75-60 mL/min per 1.73 m2 3.3
60-45 mL/min per 1.73 m2
< 45 mL/min per 1.73 m2
Szummer et al[30] 2009 NSTEMI 23 262 1-yr eGFR > 90 mL/min per 1.73 m2 16.7 5 -
89-60 mL/min per 1.73 m2 38.2 5.8
59-30 mL/min per 1.73 m2 51.2
29-15 mL/min per 1.73 m2
< 15 mL/min per 1.73 m2/HD
Mehran et al[65] 2009 NSTEMI/UA 12 939 30-d (1-yr) CrCl < 60 mL/min 3 (7.9) 1.1 (2.8) Excluded pts with CrCl < 30 mL/min
James et al[50] 2010 STEMI/NSTEMI 15 202 1-yr CrCl < 60 mL/min 12.1 3.3 Included pts admitted < 24 h from symptoms onset
Fox et al[15] 2010 STEMI 19 089 In-hospital Stage 3a 8.8 2.3 -
Stage 3b 17.9
Stage 4 27.3
Stage 5 31.8
Fox et al[15] 2010 NSTEMI 30 462 In-hospital Stage 3a 4.8 1.8 -
Stage 3b 8.6
Stage 4 13.4
Stage 5 12.4
Hachinohe et al[42] 2011 NSTEMI 3615 1-yr eGFR > 90 mL/min per 1.73 m2 9.4 4 Excluded pts with CS
89-60 mL/min per 1.73 m2 30 3
59-30 mL/min per 1.73 m2
< 30 mL/min per 1.73 m2
Hanna et al[77] 2011 NSTEMI 40 074 In-hospital eGFR > 60 mL/min per 1.73 m2 2.8 0.6 All pts were treated with PCI
59-30 mL/min per 1.73 m2 6.1
29-15 mL/min per 1.73 m2 3.9
< 15 mL/min per 1.73 m2

ACS: Acute coronary syndromes; CABG: Coronary artery bypass graft; CKD: Chronic kidney disease; CrCl: Creatinine clearance; CS: Cardiogenic shock; eGFR: Estimated glomerular filtration rate; HD: Hemodialysis; HF: Heart failure; LV: Left ventricular; NSTEMI: Non-ST elevation myocardial infarction; OR: Odds ratio; PCI: Percutaneous coronary intervention; sCr: Serum creatinine concentration; STEMI: ST-elevation myocardial infarction; UA: Unstable angina.