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title:A Prospective, Observational Trial on the Association of Chronic Kidney Disease and Anemia with Acute Coronary Syndrome

Author:Mukesh Verma, Saumya Gupta, Keemi Dalal

Keywords:Acute Coronary Syndrome, Chronic Kidney Disease, Anaemia, Cardiovascular risk factors

Type:Original Article

Abstract:"Introduction: Chronic kidney disease and anemia, both independently have been shown to be a causative factor in the development of Cardiovascular diseases. The aim of the study is to establish that both CKD and Anemia are risk factors for adverse CVD outcomes in the general population. Methods: This cross-sectional, observational, single-centre, study comprising of 108 patients. A diagnosis of acute coronary syndrome was made in each patient after obtaining an ECG and cardiac biomarkers (Troponin-T/ Troponin-I) when indicated. Normality of data was tested by Kolmogorov-Smirnov test. If the normality was rejected, then a nonparametric test was used. A p value of <0.05 was considered statistically significant. Results: Out of 108 patients, 38(35%) were diagnosed with Chronic kidney disease, whose proportion was higher in patients with STEMI (55.81%) and NSTEMI (33.36%) than those with unstable angina (13.95%) (p=0.001). The mean hemoglobin level in non-CKD patients was 11.67 gm/dl while in CKD patients it was 9.72 gm/dl. In patients with acute coronary syndrome, 78 patients (72.22%) were anemic, a much higher proportion than general population. Conclusion: Overall, our study shows that both CKD and Anemia are risk factors for adverse CVD outcomes in the general population. There is a high prevalence of CVD in subjects with CKD. Therefore regular evaluation for renal disease, should be included as routine investigations for patients with, or at a higher risk for CVD. Anemia is associated with increased cardiovascular morbidity. It appears play a causative role in the progression of CVD, especially in patients with CKD. Microcytic type was the most common. Hence large scale iron supplementation programs may have a significant benefit in reducing the cardiovascular mortality too. "

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