Introduction:
Chronic Kidney Disease (CKD) is marked by progressive reductions in glomerular filtration rate (GFR) and abnormal kidney function, with End Stage Renal Disease (ESRD) representing its final stage. CKD significantly increases cardiovascular disease (CVD) risk, with a high prevalence of cardiovascular complications. Acute Coronary Syndromes (ACS) are common among CKD patients, complicating their management due to the scarcity of targeted randomized trials. This study aims to determine CKD prevalence among ACS patients and evaluate its impact on management decisions and outcomes.
Methods:
This prospective observational study was conducted at KIMS, Karnataka, with ethical approval from the hospital’s ethics committee. Between 2023 and 2024, 1,280 ACS patients were admitted to the cardiac ICU. Of these, 328 had CKD, and 120 were newly diagnosed. Data on age, gender, ECG findings, symptoms, risk factors, coronary angiogram (CAG) results, and treatment outcomes were collected.
Results:
CKD prevalence among ACS patients was 25.6%. The cohort was predominantly males (64.2%) with a mean age of 65.5 years. Risk factors included diabetes mellitus (19.3%), hypertension (40.0%), and both (40.75%). Diabetic kidney disease was the most common cause (75.8%). Symptoms included chest pain (45.0%) and pulmonary edema (50.8%). ECG findings revealed 46.7% with STEMI and 53.3% with NSTEMI. CAG showed single-vessel disease (6.7%), double-vessel disease (20.8%), and triple-vessel disease (41.7%). CAG was not performed in 30.8% of cases due to high creatinine levels. Mortality was higher in STEMI patients (17.5%) compared to NSTEMI -ACS patients (3.3%).
Conclusions:
CKD does not necessarily reduce the success rate of reperfusion therapies but is linked to a higher incidence of major adverse events. In STEMI patients with CKD, increased mortality rates despite optimal therapy suggest that early PCI could be beneficial. Determining the optimal strategy for STEMI patients with CKD remains challenging and requires further research..
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.