Postdischarge worsening renal function strongly predicts adverse CV events
Postdischarge worsening renal function is common in patients with type 2 diabetes and acute coronary syndromes with normal or mildly depressed renal function, and a strong risk factor for adverse cardiovascular events, according to a recent study.
A total of 204 patients (7.34 percent) had worsening renal function. Over a median follow-up of 2 years, the estimated rates of death and hospital admission for heart failure per 100 person-years were 3.45 (95 percent CI, 2.46 to 6.36) for those with worsening renal function compared with 1.43 (1.14 to 1.79) for patients with stable renal function.
Adjusted analysis revealed that worsening renal function correlated with the composite endpoints of all-cause death and hospitalization for heart failure (hazard ratio, 2.65; 1.57 to 4.49; p<0.001).
In this study, researchers considered the placebo cohort of the AleCardio trial comparing aleglitazar with standard medical therapy among patients with type 2 diabetes mellitus and a recent acute coronary syndrome.
In total, 2,776 patients were included in the analysis. Excluded were those who had died or had been admitted to hospital for heart failure before the 6-month follow-up, as well as patients without complete renal function data.
Worsening renal function was defined as a >20-percent reduction in estimated glomerular filtration rate from discharge to 6 months or progression to macroalbuminuria. Cox regression analysis was used to determine the prognostic impact of 6-month renal deterioration on the composite of all-cause death and hospital admission for heart failure.
“Worsening renal function during hospitalization for an acute coronary syndrome is strongly predictive of in-hospital and long-term outcome,” researchers noted.