PMID- 22041637
OWN - NLM
STAT- MEDLINE
DCOM- 20120221
LR  - 20161125
IS  - 1421-9751 (Electronic)
IS  - 0008-6312 (Linking)
VI  - 119
IP  - 4
DP  - 2011
TI  - Timing of coronary angiography and outcome in patients with non-ST elevation 
      acute coronary syndromes and kidney disease: real-world data from the acute 
      coronary syndromes Israeli survey.
PG  - 224-34
LID - 10.1159/000332588 [doi]
AB  - OBJECTIVE: Patients with kidney disease (KD) who present with non-ST segment 
      elevation acute coronary syndromes (NSTE-ACS) may benefit from coronary 
      intervention. We evaluated the outcome of these patients who were referred for 
      early or late coronary angiography. METHODS: The risk of 1-year mortality 
      according to the presence of KD [estimated glomerular filtration rate (eGFR) <60 
      ml/min/1.73 m(2)] and the time of coronary angiography [categorized as early (</=48 
      h from admission) or late (>48 h from admission)] was assessed among 2,001 
      NSTE-ACS patients enrolled in the ACS Israeli Survey between 2004 and 2008. A 
      propensity score for early angiography was included in the proportional hazards 
      modeling of mortality. RESULTS: Patients with KD (n = 729) experienced a 2.7-fold 
      increased risk of death compared with non-KD patients (p < 0.001). Early coronary 
      angiography was associated with a lower rate of in-hospital complications and 
      30-day mortality. Both early and late angiography were associated with a lower 
      adjusted risk of 1-year mortality [hazard ratios (HRs) 0.46 (p < 0.001) and 0.59 
      (p = 0.002), respectively] compared with no angiography. In patients with severe 
      KD (eGFR <30 ml/min/1.73 m(2)), only early coronary angiography was associated 
      with a lower mortality risk (HR 0.25, 95% confidence interval 0.08-0.81). 
      CONCLUSIONS: An early invasive strategy is associated with a low mortality risk 
      in NSTE-ACS patients with KD and a more pronounced effect among those with severe 
      KD.
CI  - Copyright (c) 2011 S. Karger AG, Basel.
FAU - Young Altahan, Revital
AU  - Young Altahan R
AD  - Department of Cardiology, Assaf Harofeh Medical Center, Zerifin, Israel.
FAU - Goldenberg, Ilan
AU  - Goldenberg I
FAU - Kimron, Lizzie
AU  - Kimron L
FAU - Barsheshet, Alon
AU  - Barsheshet A
FAU - Guetta, Victor
AU  - Guetta V
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20111025
PL  - Switzerland
TA  - Cardiology
JT  - Cardiology
JID - 1266406
SB  - IM
CIN - Cardiology. 2011;120(3):135-8. PMID: 22188773
MH  - Acute Coronary Syndrome/complications/*diagnostic imaging/mortality
MH  - Aged
MH  - Coronary Angiography/*methods
MH  - Female
MH  - Glomerular Filtration Rate/physiology
MH  - Humans
MH  - Israel/epidemiology
MH  - Kaplan-Meier Estimate
MH  - Kidney Diseases/*complications/mortality/physiopathology
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Risk Factors
MH  - Time Factors
EDAT- 2011/11/02 06:00
MHDA- 2012/02/22 06:00
CRDT- 2011/11/02 06:00
PHST- 2011/07/04 00:00 [received]
PHST- 2011/08/26 00:00 [accepted]
PHST- 2011/11/02 06:00 [entrez]
PHST- 2011/11/02 06:00 [pubmed]
PHST- 2012/02/22 06:00 [medline]
AID - 000332588 [pii]
AID - 10.1159/000332588 [doi]
PST - ppublish
SO  - Cardiology. 2011;119(4):224-34. doi: 10.1159/000332588. Epub 2011 Oct 25.