Incidence & Impact of Cardio-Renal Syndrome on Top of Acute Coronary Syndrome

Abstract

A complex pathophysiology, cardio-renal syndrome (CRS), has been redefined in recent years. One subtype is acute renocardiac CRS, or CRS type 3. This syndrome is intended to comprise situations in which acute kidney injury (AKI) results in acute cardiac injury or dysfunction. The pathophysiology of CRS type 3 is not well understood. Objectives: Our study aimed to describe the incidence and impact of CRS-1 on top of ACS regarding course of the disease, length of stay in ICU and mortality. Also, to determine the AKI predictors in ACS, persistent KI predictors, all cause-mortality predictors in ACS. Patients and Methods: This is a single centre prospective observational study of CRS-1 in ACS included 40 patients diagnosed on admission as ACSs. ACS patients were divided into 2 groups: the first group included 20 patients who had EF>40% and subdivided into: 10 patients who did PCI within 48 hrs and others who received conservative treatment) and the second group included 20 patients who had EF<40% and subdivided into (10patients who did 48 hrs and others who received conservative treatment). Results: In our study, there was no statistically significant difference between groups in age and gender which denote good matching between groups. Regarding comorbidities, the current study found that patients with EF<40% had significantly higher percentage of diabetes mellitus and hypertension than group with EF>40%. With sub-group analysis, patients who did PCI in both groups had statistically significant higher percentage of hypertension and diabetes mellitus than who didn’t. The group with EF<40% had statistically significant longer length of hospital stay (days) than the other group. With sub-group analysis, patients who did PCI in both groups had statistically significant longer length of hospital stay than who didn’t. Conclusion: We found that AKI during hospitalization occurred more frequently in ACS patients with lower EF and previous PCI. Although the predominant mechanisms of AKI and its negative effect on the outcome of ACS remain to be understood, the syndrome is clearly multifactorial. The presence of preexisting comorbidities may have an impact on the incidence of AKI on top of acute CRS