RELATIONSHIP OF SERUM CREATININE RATIO AND NON-ST-SEGMENT ELEVATION ACUTE CORONARY SYNDROME

Introduction: Recent studies suggested that a higher incidence of adverse events was observed in patients with non-ST-segment elevation acute coronary syndrome (ACS) when combined with chronic renal failure (CRF). However, there is no convincing data to show the relationship of serum creatinine and adverse events in those patients. This study aimed to explore the relationship of the serum post-/pre-procedural creatinine ratio in acute coronary syndrome patients with adverse cardiovascular events. Materials and methods: 316 subjects with non-ST-segment elevation acute coronary syndrome were enrolled in the study and underwent percutaneous coronary intervention. Subjects were divided into the normal group (creatinine<97umol/L) and chronic renal failure (CRF) group (creatinine >= 97umol/L) according to the pre-procedure renal function. Serum creatinine ratio (SCrR, post-/pre-procedural) was used to determine the increase of creatinine after PCI (Group 1: SCrR<1.25; Group 2: 1.25 <= SCrR<1.5; Group 3: SCrR >= 1.5). In this study, contrast-induced nephropathy (CIN) was defined as an increased level of serum creatinine by 25% (SCrR >= 1.25) within 72 hours of PCI. In addition, each patient took aspirin and statins according to prescriptions after operation. The use of beta-blockers and angiotensin converting enzyme inhibitors was personally determined. Then, the association between SCrR and adverse cardiovascular events, such as cardiovascular related deaths, recurrent angina pectoris and myocardial infarction were investigated within one-year follow-up. Results: In our study, a higher incidence of CIN and adverse cardiovascular events could be seen in the subjects with chronic renal failure. Besides, the highest ratio of adverse events was found in the group of SCrR >= 1.5. Conclusion: There is a higher ratio of adverse cardiovascular events and contrast-induced nephropathy in subjects with chronic renal failure. In spite of renal function before operation, the incidence of adverse cardiovascular events significantly increased for those with SCrR >= 1.5.