Abstract | OBJECTIVES: METHODS: A secondary analysis of a cohort study of patients presenting to the ED with potential ACS with serum creatinine measurements. Research assistants collected demographics, history, symptoms, hospital course and 30-day follow-up. Outcomes measured were in-hospital AMI and 30-day CV events (death, nonfatal AMI, revascularisation). Prespecified multivariable models included age, gender, race and cardiac risk factors and presenting electrocardiogram (ECG). We used a creatinine cut-off point of 132.6 mmol/l. Data are presented as OR and 95% CI. RESULTS: 3451 patients were enrolled (age, 52.9±13.2; 55% female patients; 64% black patients). There were 120 AMI during initial visit and 232 patients had 30-day CV events (43 deaths, 128 AMI, 120 revascularisations). Creatinine values were normal in 3086 (89.4%) and abnormal in 365 (10.5%) patients. In multivariable models the adjusted OR (95% CI) for the association between abnormal creatinine and AMI was 1.43 (0.88 to 2.30) and 30-day CV events was 1.57 (1.10 to 2.25). The odds of 30-day CV events were increased for patients who were older, male subjects, white, had hyperlipidaemia, hypertension or a history of CAD, or presented with an abnormal ECG. CONCLUSION: In patients with potential ACS in the ED, renal dysfunction predicts a higher likelihood of 30-day CV events, but not an independent predictor after controlling for other risk factors. It appears to be a marker of other CV risks.
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Authors | Anna Marie Chang, Meredith Edwards, Asako C Matsuura, Kristy M Walsh, Emily Barrows, Jeffrey Le, Judd E Hollander |
Journal | Emergency medicine journal : EMJ
(Emerg Med J)
Vol. 30
Issue 2
Pg. 101-5
(Feb 2013)
ISSN: 1472-0213 [Electronic] England |
PMID | 22396383
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Acute Coronary Syndrome
(blood)
- Adult
- Aged
- Biomarkers
(blood)
- Cardiovascular Diseases
(epidemiology, etiology)
- Cohort Studies
- Creatinine
(blood)
- Emergency Service, Hospital
(statistics & numerical data)
- Female
- Humans
- Incidence
- Kidney Diseases
(blood, complications)
- Male
- Middle Aged
- Multivariate Analysis
- Myocardial Infarction
(epidemiology, etiology)
- Risk Factors
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