Effect Of Estimated Glomerular Filtration Rate On The Prognosis Of Acute Coronary Syndrome Patients With PCI

Objective:To analyze the effect of estimated glomerular filtration rate on the prognosis of patients with acute coronary syndrome and percutaneous coronary intervention.Methods:This study was a retrospective cohort study,and a total of 2805 patients diagnosed with ACS and PCI were collected from January 1,2010 to October 31,2014.According to the eGFR level at admission,there were 2224 patients in the eGFR1 group with eGFR≥60mL/(min·1.73 m~2),457 patients in the eGFR2 group with eGFR≥30m L/(min·1.73 m~2),and 124 patients in the eGFR3 group with eGFR<30mL/(min·1.73m~2).Follow-up was conducted from October 2015 to retrospectively analyze the differences in clinical characteristics and prognosis among the three groups.Results:With the decrease of eGFR level,the proportion of males,the number of smokers,the number of hospitalized left ventricular ejection fraction and the number of UA cases showed a gradually decreasing trend,while the number of STEMI cases,the number of hospitalized creatinine,glutamate transaminase and NT-proBNP showed a gradually increasing trend,with statistically significant differences(P<0.05).During the follow-up period,with the decrease of eGFR level,all-cause mortality and cardiogenic mortality significantly increased,and the difference was statistically significant(P<0.05),while the rate of non-fatal myocardial infarction and the rate of unplanned re-revascularization were not statistically significant.Use Cox regression model was used to analyze the relationship between glomerular filtration rate and patient prognosis.eGFR<60mL/(min·1.73 m~2)and all-cause death(eGFR2 group:HR 1.823,95%CI1.088-3.053;P=0.023;eGFR3 group:HR 2.888,95%CI 1.372-6.080;P=0.005)were found and cardiogenic death(eGFR2 group:HR 1.909,95%CI 1.069-3.409;P=0.029;eGFR3 group:HR 3.707,95%CI 1.735-7.920;P=0.001)had a significant correlation.Multivariate Cox regression analysis showed that eGFR<30m L/(min·1.73 m~2)and cardiogenic death(after adjustment HR 2.295,95%CI 1.008-5.222;P=0.048)is independent correlation.Conclusion:eGFR<60mL/(min·1.73 m~2)significantly increased the risk of all-cause and cardiogenic death in ACS patients undergoing PCI;eGFR<30mL/(min·1.73 m~2)was an independent predictor of the prognosis of ACS patients undergoing PCI.