Prognostic impact of renal dysfunction in patients with acute coronary syndrome—role beyond the CHA2DS2-VASc score: Data from Taiwan acute coronary syndrome full spectrum registry

Su Kiat Chua, Huey Ming Lo, Chiung Zuan Chiu, Kou Gi Shyu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aim: CHA2DS2-VASc score has been proven to have great prognostic value in patients with acute coronary syndrome (ACS). We aimed to determine whether the addition of renal dysfunction in the CHA2DS2-VASc score would improve the prognostic impact of the scoring system to predict prognosis among ACS patients. Methods: A total of 3031 ACS patients were prospectively enrolled at 39 hospitals and followed for 1 year. The patients were divided into three groups based on estimated glomerular filtration rate (eGFR) (group 1, eGFR>90; group 2, eGFR between 60 and 90; and group 3, eGFR2). The occurrence of subsequent myocardial infarction (MI), stroke, or death was recorded. Results: As renal function progressively decreased from group 1 to 3, the patients were, respectively older and had higher incidence of comorbidity, worse Killip classification, and less evidence-based medical therapies. The rate of subsequent MI, stroke or death increased from 3.4% in group 1 to 7.4% in group 2 and 17.2% in group 3 (P 2) and CHA2DS2-VASc scores were both significant predictors of adverse events in multivariable regression analyses. Renal dysfunction can further stratify patients with CHA2DS2-VASc score of 0 or 1 into 3 groups with different adverse event rates (group 1, 3.0%; group 2, 4.1%; and group 3, 9.2%, P 2DS2-VASc score) derived by assigning one more point for eGFR ≤ 60 mL/min per 1.73 m2 to the CHA2DS2-VASc score could improve its predictive accuracy (area under the receiver operating curve, 0.70 vs. 0.66, P 2DS2-VASc score.

Original languageEnglish
Pages (from-to)583-591
Number of pages9
JournalNephrology
Volume21
Issue number7
DOIs
Publication statusPublished - Jul 1 2016

Fingerprint

Acute Coronary Syndrome
Taiwan
Registries
Glomerular Filtration Rate
Kidney
Stroke
Myocardial Infarction
Comorbidity
Regression Analysis
Incidence

Keywords

  • CHADS-VASc score
  • death
  • myocardial infarction
  • Renal dysfunction

ASJC Scopus subject areas

  • Nephrology

Cite this

Prognostic impact of renal dysfunction in patients with acute coronary syndrome—role beyond the CHA2DS2-VASc score : Data from Taiwan acute coronary syndrome full spectrum registry. / Chua, Su Kiat; Lo, Huey Ming; Chiu, Chiung Zuan; Shyu, Kou Gi.

In: Nephrology, Vol. 21, No. 7, 01.07.2016, p. 583-591.

Research output: Contribution to journalArticle

@article{1b84af04bf1c41d399cd10be1d845ba3,
title = "Prognostic impact of renal dysfunction in patients with acute coronary syndrome—role beyond the CHA2DS2-VASc score: Data from Taiwan acute coronary syndrome full spectrum registry",
abstract = "Aim: CHA2DS2-VASc score has been proven to have great prognostic value in patients with acute coronary syndrome (ACS). We aimed to determine whether the addition of renal dysfunction in the CHA2DS2-VASc score would improve the prognostic impact of the scoring system to predict prognosis among ACS patients. Methods: A total of 3031 ACS patients were prospectively enrolled at 39 hospitals and followed for 1 year. The patients were divided into three groups based on estimated glomerular filtration rate (eGFR) (group 1, eGFR>90; group 2, eGFR between 60 and 90; and group 3, eGFR2). The occurrence of subsequent myocardial infarction (MI), stroke, or death was recorded. Results: As renal function progressively decreased from group 1 to 3, the patients were, respectively older and had higher incidence of comorbidity, worse Killip classification, and less evidence-based medical therapies. The rate of subsequent MI, stroke or death increased from 3.4{\%} in group 1 to 7.4{\%} in group 2 and 17.2{\%} in group 3 (P 2) and CHA2DS2-VASc scores were both significant predictors of adverse events in multivariable regression analyses. Renal dysfunction can further stratify patients with CHA2DS2-VASc score of 0 or 1 into 3 groups with different adverse event rates (group 1, 3.0{\%}; group 2, 4.1{\%}; and group 3, 9.2{\%}, P 2DS2-VASc score) derived by assigning one more point for eGFR ≤ 60 mL/min per 1.73 m2 to the CHA2DS2-VASc score could improve its predictive accuracy (area under the receiver operating curve, 0.70 vs. 0.66, P 2DS2-VASc score.",
keywords = "CHADS-VASc score, death, myocardial infarction, Renal dysfunction",
author = "Chua, {Su Kiat} and Lo, {Huey Ming} and Chiu, {Chiung Zuan} and Shyu, {Kou Gi}",
year = "2016",
month = "7",
day = "1",
doi = "10.1111/nep.12653",
language = "English",
volume = "21",
pages = "583--591",
journal = "Nephrology",
issn = "1320-5358",
publisher = "Wiley-Blackwell",
number = "7",

}

TY - JOUR

T1 - Prognostic impact of renal dysfunction in patients with acute coronary syndrome—role beyond the CHA2DS2-VASc score

T2 - Data from Taiwan acute coronary syndrome full spectrum registry

AU - Chua, Su Kiat

AU - Lo, Huey Ming

AU - Chiu, Chiung Zuan

AU - Shyu, Kou Gi

PY - 2016/7/1

Y1 - 2016/7/1

N2 - Aim: CHA2DS2-VASc score has been proven to have great prognostic value in patients with acute coronary syndrome (ACS). We aimed to determine whether the addition of renal dysfunction in the CHA2DS2-VASc score would improve the prognostic impact of the scoring system to predict prognosis among ACS patients. Methods: A total of 3031 ACS patients were prospectively enrolled at 39 hospitals and followed for 1 year. The patients were divided into three groups based on estimated glomerular filtration rate (eGFR) (group 1, eGFR>90; group 2, eGFR between 60 and 90; and group 3, eGFR2). The occurrence of subsequent myocardial infarction (MI), stroke, or death was recorded. Results: As renal function progressively decreased from group 1 to 3, the patients were, respectively older and had higher incidence of comorbidity, worse Killip classification, and less evidence-based medical therapies. The rate of subsequent MI, stroke or death increased from 3.4% in group 1 to 7.4% in group 2 and 17.2% in group 3 (P 2) and CHA2DS2-VASc scores were both significant predictors of adverse events in multivariable regression analyses. Renal dysfunction can further stratify patients with CHA2DS2-VASc score of 0 or 1 into 3 groups with different adverse event rates (group 1, 3.0%; group 2, 4.1%; and group 3, 9.2%, P 2DS2-VASc score) derived by assigning one more point for eGFR ≤ 60 mL/min per 1.73 m2 to the CHA2DS2-VASc score could improve its predictive accuracy (area under the receiver operating curve, 0.70 vs. 0.66, P 2DS2-VASc score.

AB - Aim: CHA2DS2-VASc score has been proven to have great prognostic value in patients with acute coronary syndrome (ACS). We aimed to determine whether the addition of renal dysfunction in the CHA2DS2-VASc score would improve the prognostic impact of the scoring system to predict prognosis among ACS patients. Methods: A total of 3031 ACS patients were prospectively enrolled at 39 hospitals and followed for 1 year. The patients were divided into three groups based on estimated glomerular filtration rate (eGFR) (group 1, eGFR>90; group 2, eGFR between 60 and 90; and group 3, eGFR2). The occurrence of subsequent myocardial infarction (MI), stroke, or death was recorded. Results: As renal function progressively decreased from group 1 to 3, the patients were, respectively older and had higher incidence of comorbidity, worse Killip classification, and less evidence-based medical therapies. The rate of subsequent MI, stroke or death increased from 3.4% in group 1 to 7.4% in group 2 and 17.2% in group 3 (P 2) and CHA2DS2-VASc scores were both significant predictors of adverse events in multivariable regression analyses. Renal dysfunction can further stratify patients with CHA2DS2-VASc score of 0 or 1 into 3 groups with different adverse event rates (group 1, 3.0%; group 2, 4.1%; and group 3, 9.2%, P 2DS2-VASc score) derived by assigning one more point for eGFR ≤ 60 mL/min per 1.73 m2 to the CHA2DS2-VASc score could improve its predictive accuracy (area under the receiver operating curve, 0.70 vs. 0.66, P 2DS2-VASc score.

KW - CHADS-VASc score

KW - death

KW - myocardial infarction

KW - Renal dysfunction

UR - http://www.scopus.com/inward/record.url?scp=84976586816&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84976586816&partnerID=8YFLogxK

U2 - 10.1111/nep.12653

DO - 10.1111/nep.12653

M3 - Article

C2 - 26469710

AN - SCOPUS:84976586816

VL - 21

SP - 583

EP - 591

JO - Nephrology

JF - Nephrology

SN - 1320-5358

IS - 7

ER -