Chronic kidney disease (CKD) is associated with an increased risk of cardiovascular disease (CVD). We examined the characteristics, management and outcomes of patients with CKD in the All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) national registry.
The cohort comprised NZ patients with an ACS undergoing coronary angiography between January 2013 and December 2016. Patients were categorised according to their stage of CKD. Outcomes included all cause and cause specific mortality, and hospitalisation with myocardial infarction, stroke and major bleeding.
Of the 20 604 patients, 20.3% had normal renal function, with 53.3%, 23.3%, 1.7% and 1.4% having CKD stages 2, 3, 4 and 5 CKD respectively. Patients with severe CKD were more likely to be MĀori or Pacific and live in an area with greater socioeconomic deprivation. Death, recurrent myocardial infarction or stroke, and major bleeding all increased incrementally with each worsening stage of CKD severity. Compared with those with normal renal function, patients with stage 5 CKD had a much higher all cause (HR 16.41, 95% CIs 13.06-20.61), cardiovascular (HR16.38, 95% CIs 12.17-22.04) and non-cardiovascular mortality (HR 13.66 9, 95% CIs.56-19.51). In addition patients with stage 5 CKD were at higher risk of recurrent MI or stroke (HR 4.73, 95% CIs 3.86-5.80) and bleeding (HR 5.84, 95% CIs 4.39-7.76).
CKD was associated with increased mortality and a high incidence of morbidity in patients undergoing coronary angiography in New Zealand. Initiatives to understand and improve outcomes in this group of patients are urgently needed. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
