O clearance de creatinina como uma ferramenta no prognóstico intra-hospitalar de pacientes com síndrome coronariana aguda

• Ano de defesa: 2018
• Autor(a) principal: Almeida, Andreza Santos
• Orientador(a): Sousa, Antônio Carlos Sobral
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Programa de Pós-Graduação: Pós-Graduação em Ciências da Saúde
• Palavras-chave em Português: Insuficiência renal; Síndrome coronariana aguda; Prognóstico
• Palavras-chave em Inglês: Renal insufficiency; Acute coronary syndrome; Prognosis
• Área do conhecimento CNPq: CIENCIAS DA SAUDE
• Link de acesso: http://ri.ufs.br/jspui/handle/riufs/7647

Background: Renal failure (RI) is a common and treatable disease. Its presentation is frequent in patients with coronary artery disease (CAD). Numerous studies have demonstrated significant increases in morbidity and mortality in patients with Acute Coronary Syndrome (ACS) and RI. However, the current prognostic models available for SCA use little of the study of renal function as a predictive and predictive factor. Objectives: To analyze renal function in patients with Acute Coronary Syndrome through creatinine clearance and to evaluate whether there is interference of renal dysfunction in the in-hospital evolution of patients with ACS. Methods: This is a longitudinal and prospective hospital cohort study performed at the Thoracic Pain Unit (UDT) of a private hospital considered a cardiological reference in Sergipe, Brazil. Subjects of both sexes with SCA and hospitalized for investigation and treatment were used during the period from May 2012 to December 2016. A total of 401 patients were included, analyzed for the presence or absence of renal damage, followed up until hospital discharge (or death). Results: The mean age of patients was 65.4 (± 13.0) years with male predominance (58.6%). Of the 324 (80.8%) patients with acute coronary syndrome without ST-segment elevation, 165 (41.1%) were suffering from unstable angina and 159 (39.6%), myocardial infarction without ST. Among the risk factors, hypertension was more prevalent (72.5%) followed by dyslipidemia (53.6%). Regarding the distribution of hospital days, there was a median of 6 days and a mean of 9 (± 12.8) days.The mean creatinine clearance was 80.8 (± 33.6) mL/min/1.73m², in which 241 patients presented with estimated glomerular filtration rate below 90 mL/min/1.73m² (OR= 1.74; CI 95% 1.11-2.71; p= 0.015) was a predictor for events. Conclusion: Patients with acute coronary syndrome and renal failure had a greater number of days of hospitalization when compared to patients without renal injury (IRR 0.9; CI 0.9-0.9; p=0.02). Therefore, assessment of renal function is an important tool for prognostic stratification in patients with ACS.