Open AccessChronic kidney disease in acute coronary syndromes
Author(s) -
Giancarlo Marenzi,
Angelo Cabiati,
Emilio Assanelli
Publication year - 2012
Publication title -
world journal of nephrology
Language(s) - Uncategorized
Resource type - Journals
ISSN - 2220-6124
DOI - 10.5527/wjn.v1.i5.134
Subject(s) - medicine , kidney disease , intensive care medicine , coronary artery disease , acute coronary syndrome , revascularization , randomized controlled trial , population , disease , epidemiology , clinical trial , renal function , myocardial infarction , environmental health
Chronic kidney disease (CKD) is associated with a high burden of coronary artery disease. In patients with acute coronary syndromes (ACS), CKD is highly prevalent and associated with poor short- and long-term outcomes. Management of patients with CKD presenting with ACS is more complex than in the general population because of the lack of well-designed randomized trials assessing therapeutic strategies in such patients. The almost uniform exclusion of patients with CKD from randomized studies evaluating new targeted therapies for ACS, coupled with concerns about further deterioration of renal function and therapy-related toxic effects, may explain the less frequent use of proven medical therapies in this subgroup of high-risk patients. However, these patients potentially have much to gain from conventional revascularization strategies used in the general population. The objective of this review is to summarize the current evidence regarding the epidemiology and the clinical and prognostic relevance of CKD in ACS patients, in particular with respect to unresolved issues and uncertainties regarding recommended medical therapies and coronary revascularization strategies.