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Non-ST elevation acute coronary syndrome treated by percutaneous coronary intervention

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eMediNexus    30 October 2017

A recent study published in the European Heart Journal compared the prognostic performance of four creatinine based formulas for the prediction of 10 year outcome in a non ST elevation acute coronary syndrome NSTE ACS population treated by percutaneous coronary intervention. Here in 222 NSTE ACS patients submitted to percutaneous coronary intervention estimated glomerular filtration rate eGFR was calculated. Different eGFR values were foundwhich showed poor agreement with the prevalence of renal dysfunction ranging from 14 to 35 . Over a median follow up of 10.2 years eGFR calculated by thechronic kidney disease epidemiology collaboration CKD Epi and Mayo quadratic formulas independently predicted outcome with an increase in the risk of death and events by up to 17 and 11 respectively for each decrement of 10 ml min 1.73 m2. In addition the Cockcroft Gault and modification of diet in renal disease MDRD equations showed a borderline association with mortality and did not predict events. When compared in terms of goodness of fit discrimination and calibration the Mayo quadratic outperformed the other formulas for the prediction of death while the CKD Epishowed the best performance for the prediction of events. Thus it was concluded that eGFR is an independent predictor of long term outcome in patients with NSTE ACS treated by percutaneous coronary intervention. It was stated that the Mayo quadratic and CKD Epi equations might be superior to classic eGFR formulas for risk stratification in these patients.

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