Patterns of Acute Coronary Syndrome and Risk Factor Profile Analysis in Patients with Impaired Renal Function

Open Access

Abstract

Background: Acute coronary syndrome remains one of the cardinal causes of cardiovascular mortality, and renal dysfunction has become an important prognostic factor. This study aimed to assess the patterns of ACS and the risk factor profile of patients with impaired renal function who presented to a tertiary care hospital in Bangladesh. Methods & Materials: This prospective observational study was conducted in the Department of Cardiology, Mymensingh Medical College Hospital, from January 2022 to December 2022. They were grouped based on creatinine clearance into normal renal function (≥70 ml/min) and impaired renal function (<70 ml/min). Demography, cardiovascular risk factors, patterns of ACS presentation, and in-hospital course regarding heart failure, arrhythmias, cardiogenic shock, mechanical complications, and mortality were noted. Data were analyzed on SPSS version 26, with p<0.05 considered significant. Results: Of 100 patients, 69% had impaired renal function with a mean age of 53.4±8.4 years compared to 47.8±7.2 years in the normal function group (p=0.002). Diabetes mellitus was significantly more prevalent in patients with impaired renal function (56.5% vs 22.6%, p=0.002). Patients with reduced creatinine clearance experienced significantly higher rates of heart failure (28.9% vs 9.6%, p=0.03), ventricular tachycardia (28.9% vs 6.4%, p=0.01), post-MI angina (34.7% vs 6.4%, p=0.002), and cardiogenic shock (21.7% vs 3.2%, p=0.02). Overall morbidity was markedly elevated in the impaired renal function group (84.0% vs 29.0%, p=0.001). Conclusion: Impaired renal function is highly prevalent among patients with ACS and is strongly related to an increase at in-hospital cardiac complications and morbidity. Systematic assessment of renal function is crucial for risk stratification and optimization of management strategies in patients with ACS.