Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study
Background: Acute coronary syndrome (ACS) accounts for the majority of ischemic heart disease-related deaths. It is known that ACS patients with chronic kidney disease (CKD) tend to have worse clinical outcomes, including major adverse coronary events (MACE) compared to patients without CKD. Some s...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Interna Publishing
2023-01-01
|
| Series: | Acta Medica Indonesiana |
| Subjects: | |
| Online Access: | https://actamedindones.org/index.php/ijim/article/view/2170 |
| _version_ | 1797855064855937024 |
|---|---|
| author | Eka Ginanjar Ni Made Hustrini Arif Mansjoer M Shiddiq Al Hanif |
| author_facet | Eka Ginanjar Ni Made Hustrini Arif Mansjoer M Shiddiq Al Hanif |
| author_sort | Eka Ginanjar |
| collection | DOAJ |
| description | Background: Acute coronary syndrome (ACS) accounts for the majority of ischemic heart disease-related deaths. It is known that ACS patients with chronic kidney disease (CKD) tend to have worse clinical outcomes, including major adverse coronary events (MACE) compared to patients without CKD. Some studies suggested that several determinant factors may be involved in this condition. Until now, research on determinant factors of MACE in ACS patients with CKD in Indonesia is still limited. Thus, we aimed to investigate the relationship of various factors to MACE in ACS patients with non-dialysis CKD who underwent percutaneous coronary intervention (PCI), in the form of neutrophile leukocyte ratio (NLR) as a factor describing chronic inflammation, left ventricular hypertrophy (LVH) as a factor describing cardiac remodeling, Gensini score may represent coronary severity, whereas GRACE was used to evaluate the severity and clinical risk of ACS patients. Methods: This study is a retrospective cohort study using secondary data from the medical records of 117 ACS patients who underwent percutaneous coronary intervention (PCI) at Cipto Mangunkusumo General Hospital Jakarta from January 2018 to June 2018 . Patients were classified based on the stage of CKD and assessed for 30-day MACE. Data were recorded on GRACE score, Gensini score, LVH, and neutrophil-lymphocyte ratio (NLR). Analysis of the relationship between these factors was carried out using the chi-square test. Results: Of the 117 patients, 62.3% were STEMI. At the end of hospital treatment, 67.5% were in the normal-stage 2 CKD group, 17.1% in the CKD stage 3a-3b group, and 15.4% in the CKD stage 4-5 group. MACE occurred in 47 (40.2%) patients with 17 (14.5%) dying. There was a significant relationship between GRACE scores and MACE (54.8% MACE at high GRACE scores vs. 32% MACE at low-moderate GRACE scores, p = 0.016, OR: 2,57 CI 95%, 1,18-5,59), while no significant relationship was found for the Gensini score, LVH, and NLR scores even though there was an increase in the proportion of MACE. Conclusion: The incidence of MACE is higher than in the previous studies conducted in the same place, i.e. Cipto Mangunkusumo General Hospital, no significant relationship is found in NLR, LVH, and Gensini score with the 30-day MACE of ACS patients with non-dialysis CKD, meanwhile the GRACE score correlates with the 30-day MACE of ACS in non-dialysis CKD patients as is the known theory regarding this score. |
| first_indexed | 2024-04-09T20:16:30Z |
| format | Article |
| id | doaj.art-715a613d20344b90aed48acc43ac36ff |
| institution | Directory Open Access Journal |
| issn | 0125-9326 2338-2732 |
| language | English |
| last_indexed | 2024-04-09T20:16:30Z |
| publishDate | 2023-01-01 |
| publisher | Interna Publishing |
| record_format | Article |
| series | Acta Medica Indonesiana |
| spelling | doaj.art-715a613d20344b90aed48acc43ac36ff2023-03-31T07:05:06ZengInterna PublishingActa Medica Indonesiana0125-93262338-27322023-01-01551564Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort StudyEka Ginanjar0Ni Made Hustrini1Arif Mansjoer2M Shiddiq Al Hanif3Division of Cardiovascular, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Nephrology-Hypertension, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDivision of Cardiovascular, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaDepartment of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, IndonesiaBackground: Acute coronary syndrome (ACS) accounts for the majority of ischemic heart disease-related deaths. It is known that ACS patients with chronic kidney disease (CKD) tend to have worse clinical outcomes, including major adverse coronary events (MACE) compared to patients without CKD. Some studies suggested that several determinant factors may be involved in this condition. Until now, research on determinant factors of MACE in ACS patients with CKD in Indonesia is still limited. Thus, we aimed to investigate the relationship of various factors to MACE in ACS patients with non-dialysis CKD who underwent percutaneous coronary intervention (PCI), in the form of neutrophile leukocyte ratio (NLR) as a factor describing chronic inflammation, left ventricular hypertrophy (LVH) as a factor describing cardiac remodeling, Gensini score may represent coronary severity, whereas GRACE was used to evaluate the severity and clinical risk of ACS patients. Methods: This study is a retrospective cohort study using secondary data from the medical records of 117 ACS patients who underwent percutaneous coronary intervention (PCI) at Cipto Mangunkusumo General Hospital Jakarta from January 2018 to June 2018 . Patients were classified based on the stage of CKD and assessed for 30-day MACE. Data were recorded on GRACE score, Gensini score, LVH, and neutrophil-lymphocyte ratio (NLR). Analysis of the relationship between these factors was carried out using the chi-square test. Results: Of the 117 patients, 62.3% were STEMI. At the end of hospital treatment, 67.5% were in the normal-stage 2 CKD group, 17.1% in the CKD stage 3a-3b group, and 15.4% in the CKD stage 4-5 group. MACE occurred in 47 (40.2%) patients with 17 (14.5%) dying. There was a significant relationship between GRACE scores and MACE (54.8% MACE at high GRACE scores vs. 32% MACE at low-moderate GRACE scores, p = 0.016, OR: 2,57 CI 95%, 1,18-5,59), while no significant relationship was found for the Gensini score, LVH, and NLR scores even though there was an increase in the proportion of MACE. Conclusion: The incidence of MACE is higher than in the previous studies conducted in the same place, i.e. Cipto Mangunkusumo General Hospital, no significant relationship is found in NLR, LVH, and Gensini score with the 30-day MACE of ACS patients with non-dialysis CKD, meanwhile the GRACE score correlates with the 30-day MACE of ACS in non-dialysis CKD patients as is the known theory regarding this score.https://actamedindones.org/index.php/ijim/article/view/2170acsckdmacegrace scoregensini scorelvhnlr |
| spellingShingle | Eka Ginanjar Ni Made Hustrini Arif Mansjoer M Shiddiq Al Hanif Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study Acta Medica Indonesiana acs ckd mace grace score gensini score lvh nlr |
| title | Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study |
| title_full | Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study |
| title_fullStr | Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study |
| title_full_unstemmed | Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study |
| title_short | Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study |
| title_sort | factors associated with 30 day major adverse cardiovascular event in acute coronary syndrome patients with non dialysis chronic kidney disease a retrospective cohort study |
| topic | acs ckd mace grace score gensini score lvh nlr |
| url | https://actamedindones.org/index.php/ijim/article/view/2170 |
| work_keys_str_mv | AT ekaginanjar factorsassociatedwith30daymajoradversecardiovasculareventinacutecoronarysyndromepatientswithnondialysischronickidneydiseasearetrospectivecohortstudy AT nimadehustrini factorsassociatedwith30daymajoradversecardiovasculareventinacutecoronarysyndromepatientswithnondialysischronickidneydiseasearetrospectivecohortstudy AT arifmansjoer factorsassociatedwith30daymajoradversecardiovasculareventinacutecoronarysyndromepatientswithnondialysischronickidneydiseasearetrospectivecohortstudy AT mshiddiqalhanif factorsassociatedwith30daymajoradversecardiovasculareventinacutecoronarysyndromepatientswithnondialysischronickidneydiseasearetrospectivecohortstudy |