Abstract
AIMS: To determine the association between baseline creatinine clearance (CrCl), coronary revascularization during index admission, and 1-year mortality in elderly patients with an acute coronary syndrome (ACS).
METHODS AND RESULTS: We estimated CrCl using the Cockcroft-Gault (CG) formula in 313 patients aged ≥ 75 years enrolled in a prospective study of treatment strategies in non ST-elevation ACS (NSTEACS). Patients were stratified into four groups according to CrCl on admission (using a cutoff of 45 ml/min) and coronary revascularization versus medical management. The mean age of the study population was 81 years and the median serum creatinine level on admission was 1.0 mg/dl (interquartile range (IQR) 0.8-1.3). Patients with impaired renal function treated medically had higher in-hospital and 1-year mortality, especially if compared with patients with preserved renal function undergoing revascularization (1-year mortality 22.9% versus 4.9%). Across the spectrum of CrCl categories, coronary revascularization was independently associated with a lower risk of mortality (HR 0.405; 95% CI 0.174-0.940; p=0.035).
CONCLUSIONS: In elderly patients with NSTEACS, coronary revascularization decreases the risk of 1-year death across each CrCl category, and is one of the most powerful predictors of 1-year outcome.
| Original language | English |
|---|---|
| Pages (from-to) | 453-460 |
| Number of pages | 8 |
| Journal | European Heart Journal: Acute Cardiovascular Care |
| Volume | 4 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - Oct 1 2015 |
Fingerprint
Keywords
- acute myocardial infarction
- chronic
- percutaneous coronary intervention
- renal disease
ASJC Scopus subject areas
- Medicine(all)
Cite this
Renal dysfunction, coronary revascularization and mortality among elderly patients with non ST elevation acute coronary syndrome. / Morici, Nuccia; De Servi, Stefano; Toso, Anna; Murena, Ernesto; Piscione, Federico; Bolognese, Leonardo; Petronio, Anna S onia; Antonicelli, Roberto; Cavallini, Claudio; Angeli, Fabio; Savonitto, Stefano.
In: European Heart Journal: Acute Cardiovascular Care, Vol. 4, No. 5, 01.10.2015, p. 453-460.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Renal dysfunction, coronary revascularization and mortality among elderly patients with non ST elevation acute coronary syndrome
AU - Morici, Nuccia
AU - De Servi, Stefano
AU - Toso, Anna
AU - Murena, Ernesto
AU - Piscione, Federico
AU - Bolognese, Leonardo
AU - Petronio, Anna S onia
AU - Antonicelli, Roberto
AU - Cavallini, Claudio
AU - Angeli, Fabio
AU - Savonitto, Stefano
PY - 2015/10/1
Y1 - 2015/10/1
N2 - AIMS: To determine the association between baseline creatinine clearance (CrCl), coronary revascularization during index admission, and 1-year mortality in elderly patients with an acute coronary syndrome (ACS).METHODS AND RESULTS: We estimated CrCl using the Cockcroft-Gault (CG) formula in 313 patients aged ≥ 75 years enrolled in a prospective study of treatment strategies in non ST-elevation ACS (NSTEACS). Patients were stratified into four groups according to CrCl on admission (using a cutoff of 45 ml/min) and coronary revascularization versus medical management. The mean age of the study population was 81 years and the median serum creatinine level on admission was 1.0 mg/dl (interquartile range (IQR) 0.8-1.3). Patients with impaired renal function treated medically had higher in-hospital and 1-year mortality, especially if compared with patients with preserved renal function undergoing revascularization (1-year mortality 22.9% versus 4.9%). Across the spectrum of CrCl categories, coronary revascularization was independently associated with a lower risk of mortality (HR 0.405; 95% CI 0.174-0.940; p=0.035).CONCLUSIONS: In elderly patients with NSTEACS, coronary revascularization decreases the risk of 1-year death across each CrCl category, and is one of the most powerful predictors of 1-year outcome.
AB - AIMS: To determine the association between baseline creatinine clearance (CrCl), coronary revascularization during index admission, and 1-year mortality in elderly patients with an acute coronary syndrome (ACS).METHODS AND RESULTS: We estimated CrCl using the Cockcroft-Gault (CG) formula in 313 patients aged ≥ 75 years enrolled in a prospective study of treatment strategies in non ST-elevation ACS (NSTEACS). Patients were stratified into four groups according to CrCl on admission (using a cutoff of 45 ml/min) and coronary revascularization versus medical management. The mean age of the study population was 81 years and the median serum creatinine level on admission was 1.0 mg/dl (interquartile range (IQR) 0.8-1.3). Patients with impaired renal function treated medically had higher in-hospital and 1-year mortality, especially if compared with patients with preserved renal function undergoing revascularization (1-year mortality 22.9% versus 4.9%). Across the spectrum of CrCl categories, coronary revascularization was independently associated with a lower risk of mortality (HR 0.405; 95% CI 0.174-0.940; p=0.035).CONCLUSIONS: In elderly patients with NSTEACS, coronary revascularization decreases the risk of 1-year death across each CrCl category, and is one of the most powerful predictors of 1-year outcome.
KW - acute myocardial infarction
KW - chronic
KW - percutaneous coronary intervention
KW - renal disease
UR - http://www.scopus.com/inward/record.url?scp=84975275139&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84975275139&partnerID=8YFLogxK
U2 - 10.1177/2048872614557221
DO - 10.1177/2048872614557221
M3 - Article
C2 - 25348274
AN - SCOPUS:84975275139
VL - 4
SP - 453
EP - 460
JO - European Heart Journal: Acute Cardiovascular Care
JF - European Heart Journal: Acute Cardiovascular Care
SN - 2048-8726
IS - 5
ER -