Prognostic significance of serum creatinine and its change patterns in patients with acute coronary syndromes

American Heart Journal
Giancarlo MarenziAntonio Bartorelli

Abstract

In acute coronary syndromes (ACS), serum creatinine (sCr) levels have short- and long-term prognostic value. However, it is possible that repeated evaluations of sCr during hospitalization, rather than measuring sCr value at admission only, might improve risk assessment. We investigated the relationship between sCr baseline value, its changes, and in-hospital mortality in patients hospitalized with ACS. In 2,756 ACS patients, sCr was measured at hospital admission and then daily, until discharge from coronary care unit. Patients were grouped according to the maximum sCr change observed: <0.3 mg/dL change from baseline (stable renal function [SRF] group), ≥0.3 mg/dL decrease (improved renal function [IRF] group), and ≥0.3 mg/dL increase (worsening renal function [WRF] group). Of the 2,756 patients, 2,163 (78%) had SRF, 292 (11%) had IRF, and 301 (11%) had WRF. In-hospital mortality in the 3 groups was 0.5%, 2%, and 14% (P < .001), respectively. Peak sCr value was a more powerful predictor of mortality (area under the curve 0.86, 95% CI 0.81-0.92) than the initial sCr value (area under the curve 0.69, 95% CI 0.63-0.77; P < .001). When sCr and its change patterns during coronary care unit stay were evaluated together, improved mor...Continue Reading

References

Sep 15, 2000·Journal of the American College of Cardiology·P A McCulloughS Borzak
Oct 2, 2002·Annals of Internal Medicine·Michael G ShlipakMark B McClellan
Oct 2, 2002·Annals of Internal Medicine·R Scott WrightAllan S Jaffe
Oct 29, 2003·Archives of Internal Medicine·Christopher B GrangerUNKNOWN Global Registry of Acute Coronary Events Investigators
Nov 11, 2003·Journal of the American College of Cardiology·C Michael GibsonUNKNOWN TIMI Study Group
Apr 13, 2004·American Heart Journal·Frederick A MasoudiJohn S Rumsfeld
Apr 17, 2004·Journal of Thrombosis and Thrombolysis·Hans-Peter HobbachPeter Schuster
Jun 10, 2004·JAMA : the Journal of the American Medical Association·Kim A EagleUNKNOWN GRACE Investigators
Nov 3, 2004·Journal of the American College of Cardiology·Giancarlo MarenziAntonio L Bartorelli
Jun 27, 2007·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Adeera LevinUNKNOWN Acute Kidney Injury Network Working Group
May 14, 2008·Archives of Internal Medicine·Chirag R ParikhHarlan M Krumholz
Jan 19, 2011·Circulation·Matthew T JamesUNKNOWN Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators
Jan 1, 2013·The American Journal of Cardiology·Giancarlo MarenziAntonio L Bartorelli
Jan 8, 2014·Critical Care : the Official Journal of the Critical Care Forum·Stuart L GoldsteinJohn A Kellum

❮ Previous
Next ❯

Citations

Dec 29, 2015·Critical Care : the Official Journal of the Critical Care Forum·Chih-Chung ShiaoUNKNOWN National Taiwan University Hospital Study Group on Acute Renal Failure (NSARF) and the Taiwan Consortium for Acute Kidney In
Mar 18, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Olga LaszczyńskaAna Azevedo
Sep 22, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Yusuke UemuraUNKNOWN N-registry investigators
Mar 28, 2021·Clinical Nursing Research·Aiqun ZhuJingping Zhang
Apr 17, 2017·Kidney International·Sebastian Johannes ReinstadlerBernhard Metzler

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiogenic Shock

Cardiogenic shock is a devastating consequence of acute myocardial infarction and is associated with an extremely high mortality. Here is the latest research.