title: [Impact of timing of intervention on prognosis of non-ST segment elevation acute coronary syndrome patients with renal dysfunction].
abstract: OBJECTIVE
  To investigate the effects of intervention treatment in relation to renal function in patients with non-ST segment elevation acute coronary syndrome (NSTEACS).
  
  
  METHODS
  A total of 815 NSTEACS patients were randomized to receive either early intervention (coronary angiography within 24 h of randomization) or delayed intervention (coronary angiography over 36 h after randomization). Serum creatinine was determined in 781 patients at admission and glomerular filtration rate (eGFR) calculated by the abbreviated MDRD formula. The subjects were stratified according to eGFR≥90 ml×min(-1)·(1.73 m2)(-1), 60≤eGFR<90 ml×min(-1)·(1.73 m2)(-1) and eGFR<60 ml×min(-1)·(1.73 m2)(-1) and followed up for 180 days. Death, myocardial infarction or stroke was regarded as the primary end point.
  
  
  RESULTS
  Incidence of the primary end point was 6.3% at eGFR≥90 ml×min(-1)(1.73 m2)(-1), 10.1% at 60≤eGFR<90 ml×min(-1)·(1.73 m2)(-1) and 15.5% at eGFR<60 ml×min(-1)·(1.73 m2)(-1) (P=0.032). The 180 day mortality was 1.9% at eGFR≥90 ml×min(-1) (1.73 m2)(-1), 2.6% at 60≤eGFR<90 ml×min(-1)·(1.73 m2)(-1) and 9.1% at eGFR<60 ml×min(-1)·(1.73 m2)(-1) (P=0.01). In a logistic regression analysis, adjusting for other important covariables, the delayed intervention remained independently associated with the risk of primary end point in 60≤eGFR<90 ml×min(-1)·(1.73 m2)(-1) group (odds ratio, 2.106 ; 95% confidence interval, 1.102-4.024).
  
  
  CONCLUSIONS
  The strategy of early intervention reduces the risk of death/MI or stroke at 180 days in NSTEACS patients with mild renal dysfunction.
authors.affiliation: Fuwai Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, China.
authors.forename: Chun-li
authors.initials: CL
authors.lastname: Shao
authors.forename: Shu-bin
authors.initials: SB
authors.lastname: Qiao
authors.forename: Jun
authors.initials: J
authors.lastname: Zhu
authors.forename: Jue
authors.initials: J
authors.lastname: Chen
authors.forename: Wei-xian
authors.initials: WX
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yan
authors.initials: Y
authors.lastname: Liang
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.forename: Wen-jia
authors.initials: WJ
authors.lastname: Zhang
authors.forename: Man
authors.initials: M
authors.lastname: Wang
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D000368:Aged; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D051437:Renal Insufficiency; D012307:Risk Factors