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

University Heart Journal ◽

10.3329/uhj.v8i2.16079 ◽

2013 ◽

Vol 8 (2) ◽

pp. 90-97

Author(s):

CM Shaheen Kabir ◽

Fazila Tun-Nesa Malik ◽

Abdul Malik ◽

M Maksumul Haq ◽

Syed Dawood Md Taimur ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Chronic Kidney Disease ◽

Coronary Artery ◽

Kidney Disease ◽

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. DOI: http://dx.doi.org/10.3329/uhj.v8i2.16079 University Heart Journal Vol. 8, No. 2, July 2012

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Characteristics and in Hospital Clinical Outcome of Patients with Non St-Segment Elevation Myocardial Infarction with Chronic Kidney Disease

Cardiovascular Journal ◽

10.3329/cardio.v5i2.14305 ◽

2013 ◽

Vol 5 (2) ◽

pp. 146-153

Author(s):

CMS Kabir ◽

FN Malik ◽

A Malik ◽

MM Haq ◽

SDM Taimur ◽

...

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Glomerular Filtration Rate ◽

Kidney Disease ◽

Glomerular Filtration ◽

Filtration Rate ◽

Estimated Glomerular Filtration Rate ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment

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. The purpose of the present study was to evaluate the in-hospital outcome of 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. Presence of inhospital complications was identified. 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 patients had more atypical presentation during admission. In-hospital complications were significantly higher in CKD patients presenting with NSTEMI. Conclusion: CKD strongly predicts adverse in-hospital outcome among NSTEMI patients. DOI: http://dx.doi.org/10.3329/cardio.v5i2.14305 Cardiovasc. j. 2013; 5(2): 146-153

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Acute Coronary Syndromes in Chronic Kidney Disease: Clinical and Therapeutic Characteristics

Medicina ◽

10.3390/medicina56030118 ◽

2020 ◽

Vol 56 (3) ◽

pp. 118 ◽

Cited By ~ 6

Author(s):

Mădălina Ioana Moisi ◽

Marius Rus ◽

Simona Bungau ◽

Dana Carmen Zaha ◽

Diana Uivarosan ◽

...

Keyword(s):

Myocardial Infarction ◽

Coronary Artery Disease ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Acute Coronary Syndromes ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

St Segment ◽

Coronary Syndromes ◽

Artery Disease

Background and Objectives: This study evaluated the clinical characteristics of the acute coronary syndromes (ACS) in chronic kidney disease (CKD) patients and established prognostic values of the biomarkers and echocardiography. Materials and Methods: 273 patients admitted to the cardiology department of the Clinical County Emergency Hospital of Oradea, Romania, with ACS diagnosis were studied. Two study groups were formed according to the presence of CKD (137 patients with ACS + CKD and 136 with ACS without CKD). Kidney Disease: Improving Global Outcomes (KDIGO) threshold was used to assess the stages of CKD. Results: Data regarding the medical history, laboratory findings, biomarkers, echocardiography, and coronary angiography were analysed for both groups. ACS parameters were represented by ST-segment elevation myocardial infarction (STEMI), which revealed a greater incidence in subjects without CKD (43.88%); non-ST-segment elevation myocardial infarction (NSTEMI), characteristic for the CKD group (28.47%, with statistically significance p = 0.04); unstable angina and myocardial infarction with nonobstructive coronary arteries (MINOCA). Diabetes mellitus, chronic heart failure, previous stroke, and chronic coronary syndrome were more prevalent in the ACS + CKD group (56.93%, p < 0.01; 41.61%, p < 0.01; 18.25%, p < 0.01; 45.26%, p < 0.01). N-terminal pro b-type natriuretic peptide (NT-proBNP) was statistically higher (p < 0.01) in patients with CKD; Killip class 3 was evidenced more frequently in the same group (p < 0.01). Single-vessel coronary artery disease (CAD) was statistically more frequent in the ACS without CKD group (29.41%, p < 0.01) and three-vessel CAD or left main coronary artery disease (LMCA) were found more often in the ACS + CKD group (27.01%, 14.6%). Conclusions: Extension of the CAD in CKD subjects revealed an increased prevalence of the proximal CAD, and the involvement of various coronary arteries is characteristic in these patients. Biomarkers and echocardiographic elements can outline the evolution and outcomes of ACS in CKD patients.

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