Cardiac Patients with Kidney Disease Fare Worse

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Kidney disease is present in nearly one third of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and it is a strong independent predictor of subsequent mortality, new findings show.

Ilan Goldenberg, MD, of Neufeld Cardiac Research Institute, Sheba Medical Center, Tel-Hashomer, Israel, and collaborators, evaluated the risk of in-hospital and 30-day mortality according to the presence of kidney disease, defined as an estimated glomerular filtration rate of less than 60 mL/min/1.73 m2 among 13,141 patients with NSTE-ACS who participated in the European Public Health Outcome Research and Indicators Collection Project.

Of the 13,141 patients, 4,181 (31.8%) had kidney disease. Their rates of in-hospital and 30-day mortality (5.4% and 7.2%, respectively) were significantly higher than those for patients without kidney disease (1.1% and 1.7%, respectively), according to a report in Archives of Internal Medicine (2010;170:888-895).

After adjusting for potential confounders, kidney disease was associated with a twofold increased risk of in-hospital and 30-day mortality.

In addition, patients with kidney disease who underwent coronary angiography had a 36% and 40% decreased risk of in-hospital and 30-day mortality, respectively, compared with those who did not undergo the procedure. Still, this high-risk population had significantly higher case-fatality rates during hospitalization (3.3%) and at 30 days (4.6%) compared with patients who did not have KD and underwent coronary angiography.

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