Reply to letter to the editor “The impact of chronic kidney disease in patients with non-ST-segment elevation myocardial infarction undergoing revascularization procedures.”

Background: Nearly 40% of patients presenting with Non ST-Segment Elevation Myocardial Infarction (NSTEMI) have Chronic Kidney Disease (CKD). CKD is a powerful predictor of adverse events among NSTEMI patients. CKD is associated with a high prevalence of obstructive coronary artery disease. Objectives: The purpose of the present study was to evaluate the severity of coronary artery disease in patients with Chronic Kidney Disease presenting with Non ST-Segment Elevation Myocardial Infarction. Methods: In this prospective observational study a total of 128 patients with NSTEMI were enrolled. They were divided equally in group I (NSTEMI with CKD) and group II (NSTEMI with normal renal function) on the basis of estimated glomerular filtration rate. Patients were considered to have CKD if he/she had documented history of CKD or estimated glomerular filtration rate <60 mL/min/1.73 m². Angiographic severity of CAD was assessed by evaluation of number of involved vessel, site of lesion, % of stenosis, ACC/ AHA lesion classification (Type A, B, C) and TIMI flow grade between the groups. Results: Patients with CKD were significantly older, with a greater prevalence of hypertension, diabetes mellitus, lower left ventricular ejection fraction, and lower haemoglobin level compared with those without CKD. CKD was associated with an increased risk of triple vessel and left main disease. Conclusion: CKD strongly predicts severe coronary artery disease profile among NSTEMI patients. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16079 University Heart Journal Vol. 8, No. 2, July 2012

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Coronary Angiographic Profile of Patients with Acute Non ST-Segment Elevation Myocardial Infarction with Chronic Kidney Disease

University Heart Journal ◽

10.3329/uhj.v11i1.27595 ◽

2016 ◽

Vol 11 (1) ◽

pp. 18-25

Author(s):

CM Shaheen Kabir ◽

Fazila Tun Nesa Malik ◽

Abdul Malik ◽

M Maksumul Haq ◽

Syed Dawood Md Taimur ◽

...

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Coronary Artery ◽

Kidney Disease ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Artery Disease

Background: Nearly 40% of patients presenting with Non ST-Segment Elevation Myocardial Infarction (NSTEMI) have Chronic Kidney Disease (CKD). CKD is a powerful predictor of adverse events among NSTEMI patients. CKD is associated with a high prevalence of obstructive coronary artery disease.Objectives: The purpose of the present study was to evaluate the severity of coronary artery disease in patients with Chronic Kidney Disease presenting with Non ST-Segment Elevation Myocardial Infarction. Methods: In this prospective observational study a total of 128 patients with NSTEMI were enrolled. They were divided equally in group I (NSTEMI with CKD) and group II (NSTEMI with normal renal function) on the basis of estimated glomerular filtration rate. Patients were considered to have CKD if he/she had documented history of CKD or estimated glomerular filtration rate <60 mL/min/1.73 m². Angiographic severity of CAD was assessed by evaluation of number of involved vessel, site of lesion, % of stenosis, ACC/AHA lesion classification (Type A, B, C) and TIMI flow grade between the groups.Results: Patients with CKD were significantly older, with a greater prevalence of hypertension, diabetes mellitus, lower left ventricular ejection fraction, and lower haemoglobin level compared with those without CKD. CKD was associated with an increased risk of triple vessel and left main disease.Conclusion: CKD strongly predicts severe coronary artery disease profile among NSTEMI patients.University Heart Journal Vol. 11, No. 1, January 2015; 18-25

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Faculty Opinions recommendation of Use of evidence-based therapies in short-term outcomes of ST-segment elevation myocardial infarction and non-ST-segment elevation myocardial infarction in patients with chronic kidney disease: a report from the National Cardiovascular Data Acute Coronary Treatment and Intervention Outcomes Network registry.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1818956.1356054 ◽

2010 ◽

Author(s):

Peter Sinnaeve ◽

Mark Coosemans

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Evidence Based ◽

Short Term ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

National Cardiovascular

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Prognostic Implications of Chronic Kidney Disease on Patients Presenting with ST-Segment Elevation Myocardial Infarction with versus without Stent Thrombosis

Cardiorenal Medicine ◽

10.1159/000455905 ◽

2017 ◽

Vol 7 (2) ◽

pp. 150-157 ◽

Cited By ~ 2

Author(s):

Gilad Margolis ◽

Shahar Vig ◽

Nir Flint ◽

Shafik Khoury ◽

Michael Barkagan ◽

...

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Stent Thrombosis ◽

Univariate Analysis ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Long Term Mortality

Background: Limited data is present regarding long-term outcomes in chronic kidney disease (CKD) patients presenting with stent thrombosis (ST). We evaluated the possible implications of CKD on long-term mortality in patients presenting with ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI), and its interaction with the presence of ST. Methods: We retrospectively studied 1,722 STEMI patients treated with primary PCI. Baseline CKD was categorized as an estimated glomerular filtration rate <60 mL/min/1.73 m2 at presentation. The presence of ST was determined using the Academic Research Consortium definitions. Patients were evaluated for the presence of CKD and ST, as well as for long-term mortality. Results: A total of 448/1,722 (26%) patients had baseline CKD. Patients with CKD were older and had more comorbidities and a higher rate of ST (4 vs. 7%, respectively, p < 0.001). In a univariate analysis, long-term mortality was significantly higher among those with CKD compared to those without CKD (17.6 vs. 2.7%, p < 0.001). The presence of ST did not alter long-term mortality in both CKD and no-CKD patients. In a Cox regression model, CKD was an independent predictor of long-term mortality (hazard ratio 2.04, 95% confidence interval 1.17-3.56, p = 0.01), while ST as a covariate was not significantly associated with long-term mortality. Conclusion: Among STEMI patients, CKD, but not ST, is a predictor of long-term mortality.

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