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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Patients with advanced chronic kidney disease (CKD) presenting with acute coronary syndrome (ACS) have an unfavorable prognosis. The optimal management strategy, whether to adopt an early invasive approach with coronary angiography (CAG) followed by revascularization or a conservative approach with optimal medical therapy and CAG reserved for refractory ischemia, remains uncertain because this population is often excluded or underrepresented in clinical studies. While coronary angiography carries a high risk of contrast-associated acute kidney injury, uncorrected coronary lesions may also worsen renal function through cardiorenal syndrome (CRS). This study aims to evaluate the impact of CAG on renal outcomes, timing of dialysis initiation, and mortality in patients with concomitant advanced CKD and ACS.
Medical records of patients with CKD G4-5 not on renal replacement therapy (RRT) who are admitted to our hospital due to ACS between 1 January 2017 and 31 December 2021 were retrospectively reviewed. Those with shock, post-cardiac arrest, and fulfilled for palliative care were excluded. Various outcomes, including RRT initiation and death within 3 years of admission, were compared using binary logistic regression between those receiving medication treatment, CAG, and delayed CAG (>72 hours from admission).
139 patients (mean age 76±11 years, 53% male, 72% diabetes, 41% with preexisting coronary artery disease, mean glomerular filtration rate18±8 mL/min/1.73m2) were included with balanced baseline characteristics across treatment groups (41, 55, 43 patients in medication, CAG, and delayed CAG groups, respectively). Only those in the delayed CAG group posed a significant risk of acute dialysis in the admission but did not increase long-term risk of RRT. The early CAG strategy was not associated with any short- and long-term adverse renal outcomes. Moreover, all-cause death within 3 years was lower in the CAG groups compared to medication treatment group. These findings persisted after adjusting for age and important co-morbidities (Table 1).
Table 1 Unadjusted and adjusted odds ratios for various outcomes in advanced chronic kidney disease patients with acute coronary syndrome receiving coronary angiography and delayed coronary angiography (>72 hours from admission), compared to the group receiving medication treatment. The adjusted model accounted for age, diabetes status, preexisting ischemic heart disease, preexisting chronic heart failure, and preexisting cerebrovascular disease.
Early CAG strategy, as compared to medication treatment or a more delayed CAG, in advanced CKD patients presenting with ACS is not associated with increased risk of RRT and may poses a long-term survival benefit.
