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- W2113264940 abstract "Mild renal impairment is known to be associated with an increased risk of coronary artery disease and stroke, but the prognostic significance of creatinine clearance in patients hospitalized with acute coronary syndrome (ACS) is unknown. Data from the Global Registry of Acute Cardiac Events (GRACE) were examined to determine whether creatinine clearance at admission is an independent predictor of hospital mortality and adverse outcomes in patients with ACS. The study sample of 11,774 patients with ACS and available renal function data was divided into 3 groups according to creatinine clearance rates: greater than 60 mL/min (normal or minimally impaired renal function; 7,591 patients); 30 to 60 mL/min (moderate renal dysfunction; 3,397 patients); and less than 30 mL/min (severe renal dysfunction, 786 patients). Patients were also categorized as having ST-segment elevation myocardial infarction (STEMI) or non–ST-segment elevation myocardial infarction/unstable angina (NSTEMI/UA). Inhospital outcomes were compared according to renal function, demographic and clinical characteristics, and medication use. Compared with patients whose renal function was normal or near normal, those with moderate or severe renal dysfunction were older, more likely to be women, and more likely to have more comorbidities on admission. There was an association between worsening renal dysfunction and both the frequency of ECG changes and the risk of major bleeding. In patients with STEMI, ECG changes were seen less often as renal impairment increased. Patients with moderate or severe renal dysfunction were more likely to have received drugs to treat or prevent renal and atherosclerotic disease before hospital admission, but they were less likely to receive such agents during acute hospitalization. Patients with moderate renal dysfunction were twice as likely to die, and those with severe renal dysfunction were 4 times more likely to die, than patients with normal or near normal renal function. This elevated risk remained after adjustment for other variables. Creatinine clearance is an important independent predictor of hospital death and major bleeding episodes in patients with ACS. Even moderate renal insufficiency significantly increases these risks." @default.
- W2113264940 created "2016-06-24" @default.
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- W2113264940 date "2004-08-01" @default.
- W2113264940 modified "2023-10-14" @default.
- W2113264940 title "Creatinine clearance and adverse hospital outcomes in patients with acute coronary syndromes: findings from the Global Registry of Acute Coronary Events (GRACE)" @default.
- W2113264940 doi "https://doi.org/10.1016/j.annemergmed.2004.05.016" @default.
- W2113264940 hasPublicationYear "2004" @default.
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