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Subject Area

Urology

Article Type

Original Study

Abstract

Background Worsening renal function has been shown to be associated with poor outcomes in patients with acute coronary syndrome (ACS). Objective To assess the prognostic value of renal function test in patients with ACS. Patients and methods This cross-sectional observational study included 100 patients with ACS. Serum creatinine levels were measured on admission, after 48 h and at the time of discharge. Patients were divided according to the change in serum creatinine into three groups: group I (69 patients), with serum creatinine change less than 0.3 mg/dl; group II (15 patients), with a decrease in serum creatinine more than or equal to 0.3 mg/dl; group III (16 patients), with an increase in serum creatinine more than or equal to 0.3 mg/dl. The relationship between serum creatinine and in-hospital outcomes, complications, and mortality was evaluated. Results The prevalence of diabetes was significantly higher in group III compared with other groups (P < 0.05). Patients in group III had significantly lower ejection fraction (P < 0.001). In-hospital mortality was 13% in group I, 6.7% in group II, and 81.2% in group III (P < 0.001). Acute pulmonary edema, cardiogenic shock, and the need for mechanical ventilation were more prevalent significantly in group III. The cutoff point of peak serum creatinine more than 2.3 mg/dl during admission had 93.3% sensitivity and 97.7% specificity in predicting in-hospital mortality. Conclusion In ACS patients, daily serum creatinine level and its change patterns are strong predictors of in-hospital complications and mortality. Renal function test has a good prognostic value in identifying high-risk patients.

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