轻度肾功能异常与急性冠脉综合征行经皮冠状动脉介入治疗预后的关系

目的:了解接受经皮冠状动脉介入治疗(PCI)且血肌酐正常的急性冠脉综合征(ACS)患者的肾功能状态,探讨轻度肾功能异常与ACS患者预后的关系。方法:入选成功接受PCI且血肌酐在正常范围内的ACS患者,根据估算的肾小球滤过率(e GFR)评估肾功能后分组,评价不同肾功能分组患者的临床特征、预后,探讨发生不良预后的独立危险因素。结果:轻、中度肾功能异常组全因死亡率及主要不良心脑血管事件(MACCE)总发生率均明显高于肾功能正常组(P<0.05)。Logistic回归分析显示年龄及左室射血分数(LVEF)是ACS患者行PCI后不良预后的独立危险因素(P<0.05)。结论:轻度肾功能异常与冠脉介入治疗后的不良事件有关,但不是不良预后的独立危险因素。

Impact of mild renal abnormalities on prognosis of patients with acute coronary syndrome after PCI

AIM: To determine the actual status of renal function in acute coronary syndrome( ACS) patients with normal serum creatinine after percutanous coronary intervention( PCI) and to explore the impact of mild renal abnormalities( RA) on adverse clinic outcomes of ACS patients after PCI. METHODS: Two hundred and eight ACS patients with normal serum creatinine following PCI were divided into three groups based on estimated glomerular filtration rate( e GFR) : Group I with e GFR 60-89 ml /( min·1. 73 m2)( mild RA group),Group Ⅱ with e GFR 30-59 ml/( min·1. 73 m2)( moderate RA group) and Group III with e GFR ≥90 ml /( min·1. 73 m2)( non-RA group). Clinical characteristics and clinical outcomes were evaluated in different groups and independent risk factors that may affect major adverse cardiac and cerebrovascular events( MACCE) were investigated. RESULTS: All-cause mortality and total incidence of MACCE in mild RA group and in moderate RA group were obviously higher than those in non-RA group( P < 0. 05). Logistic regression analysis found that age and left ventricular ejection fraction( LVEF) were independent risk factors of adverse outcomes in patients with ACS after PCI( P < 0. 05).CONCLUSION: Mild to moderate renal abnormalities is common in ACS patients with normal serum creatinine but are not independent risk factors for poor prognosis.