Mild Renal Insufficiency and Attributable Risk of Adverse In-hospital Outcomes in Patients with ACS from the Improving Care for Cardiovascular Disease in China (CCC) Project
Abstract Background: Renal insufficiency (RI) is a frequent comorbidity among patients with acute coronary syndrome (ACS). We aimed to evaluate the attributable risk associated with mild RI for the in-hospital outcomes in patients with ACS. Methods: The Improving Care for Cardiovascular Disease in China-ACS (CCC-ACS) Project was a collaborative study of the American Heart Association and the Chinese Society of Cardiology. A total of 92509 inpatients with a discharge diagnosis of ACS were included. The attributable risk was calculated to investigate the effect of mild RI (eGFR 60-89 ml / min · 1.73 m2) on major adverse cardiovascular events (MACE) during hospitalization. Results: The average age of these ACS patients was 63 years, and 73.9% were men. The proportion of patients with mild RI was 36.17%. After adjusting for other possible risk factors, mild RI was still an independent risk factor for MACE in ACS patients. In the ACS patients, the attributable risk of eGFR 60-89ml/min·1.73m2 to MACE was 8.96%, 5.59% of eGFR 45-59 ml/min·1.73m2 ,5.31% of eGFR 30-44 ml/min·1.73m2, and 4.03% of eGFR<30 ml/min·1.73m2. Conclusion: Compared with moderate to severe RI, mild RI has higher attributable risk to MACE during hospitalization in Chinese ACS population.