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
Mar 13, 1999·Annals of Internal Medicine·A S LeveyD Roth
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
Aug 19, 2003·Heart·J J SantopintoUNKNOWN GRACE Investigators
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
Nov 16, 2004·European Heart Journal·C Michael GibsonUNKNOWN TIMI Study Group
Apr 25, 2007·American Heart Journal·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
Feb 5, 2009·Annals of Internal Medicine·Giancarlo MarenziAntonio L Bartorelli
Aug 26, 2009·Circulation·Karolina SzummerUNKNOWN SWEDEHEART
Oct 1, 2009·Critical Care Medicine·Giancarlo MarenziAntonio L Bartorelli
Jan 13, 2010·Circulation·Caroline S FoxUNKNOWN Acute Coronary Treatment and Intervention Outcomes Network registry
Dec 15, 2010·American Heart Journal·Amit P AminFrederick A Masoudi
Jan 19, 2011·Circulation·Matthew T JamesUNKNOWN Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators
Nov 19, 2011·American Heart Journal·Matthew T RoeEric D Peterson
Dec 20, 2011·Circulation·Caroline S FoxStephen D Wiviott
Nov 24, 2012·JACC. Cardiovascular Interventions·Tullio PalmeriniGregg W Stone
Jan 1, 2013·The American Journal of Cardiology·Giancarlo MarenziAntonio L Bartorelli
Apr 6, 2013·The American Journal of Cardiology·Joon Seok ChoiSoo Wan Kim
Jan 8, 2014·Critical Care : the Official Journal of the Critical Care Forum·Stuart L GoldsteinJohn A Kellum
Mar 25, 2014·The American Journal of Cardiology·Naohiko NemotoMasato Nakamura
Citations
Feb 28, 2016·International Journal of Cardiology·Marco CentolaStefano Carugo
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
Apr 19, 2018·Journal of the American Heart Association·Oanh Kieu NguyenEthan A Halm
Nov 6, 2018·Heart and Vessels·Kenichiro OtsukaMinoru Yoshiyama
Mar 18, 2020·Journal of Investigative Medicine : the Official Publication of the American Federation for Clinical Research·Olga LaszczyńskaAna Azevedo
Aug 4, 2018·Scientific Reports·Meng-Xiao FengYuan-Qiang Lu
May 14, 2020·Journal of Clinical Medicine·Nicola CosentinoGiancarlo Marenzi
Sep 3, 2020·Medicine·Hong LiuYongli Gao
Sep 22, 2020·Cardiovascular Revascularization Medicine : Including Molecular Interventions·Yusuke UemuraUNKNOWN N-registry investigators
Mar 28, 2021·Clinical Nursing Research·Aiqun ZhuJingping Zhang
Mar 31, 2021·BMC Cardiovascular Disorders·Side GaoHongwei Li
Apr 17, 2017·Kidney International·Sebastian Johannes ReinstadlerBernhard Metzler