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Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study

ACTA MEDICA INDONESIANA · Vol. 55 No. 1 (2023)

ISSN
2338-2732, 0125-9326
Terbit
2023-03-31
Penerbit
The Indonesian Society of Internal Medicine
Bahasa
eng

Abstrak

Background: Acute coronary syndrome (ACS) accounts for the majority of ischemic heart disease-related deaths. It is known that ACS patients with chronic kidney disease (CKD) tend to have worse clinical outcomes, including major adverse coronary events (MACE) compared to patients without CKD. Some studies suggested that several determinant factors may be involved in this condition. Until now, research on determinant factors of MACE in ACS patients with CKD in Indonesia is still limited. Thus, we aimed to investigate the relationship of various factors to MACE in ACS patients with non-dialysis CKD who underwent percutaneous coronary intervention (PCI), in the form of neutrophile leukocyte ratio (NLR) as a factor describing chronic inflammation, left ventricular hypertrophy (LVH) as a factor describing cardiac remodeling, Gensini score may represent coronary severity, whereas GRACE was used to evaluate the severity and clinical risk of ACS patients. Methods: This study is a retrospective cohort study using secondary data from the medical records of 117 ACS patients who underwent percutaneous coronary intervention (PCI) at Cipto Mangunkusumo General Hospital Jakarta from January 2018 to June 2018. Patients were classified based on the stage of CKD and assessed for 30-day MACE. Data were recorded on GRACE score, Gensini score, LVH, and neutrophil-lymphocyte ratio (NLR). Analysis of the relationship between these factors was carried out using the chi-square test. Results: Of the 117 patients, 62.3% were STEMI. At the end of hospital treatment, 67.5% were in the normal-stage 2 CKD group, 17.1% in the CKD stage 3a-3b group, and 15.4% in the CKD stage 4-5 group. MACE occurred in 47 (40.2%) patients with 17 (14.5%) dying. There was a significant relationship between GRACE scores and MACE (54.8% MACE at high GRACE scores vs. 32% MACE at low-moderate GRACE scores, p = 0.016, OR: 2,57 CI 95%, 1,18-5,59), while no significant relationship was found for the Gensini score, LVH, and NLR scores even though there was an increase in the proportion of MACE. Conclusion: The incidence of MACE is higher than in the previous studies conducted in the same place, i.e. Cipto Mangunkusumo General Hospital, no significant relationship is found in NLR, LVH, and Gensini score with the 30-day MACE of ACS patients with non-dialysis CKD, meanwhile the GRACE score correlates with the 30-day MACE of ACS in non-dialysis CKD patients as is the known theory regarding this score.

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  • Institut Agama Islam Negeri Bone
  • University of Indonesia
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Rekan penulisOrganisasiArtikel bersama
Idrus AlwiAfiliasi tidak diketahui6
Andhika RachmanAfiliasi tidak diketahui5
Simon SalimAfiliasi tidak diketahui5
Kuntjoro HarimurtiAfiliasi tidak diketahui5
Sally Aman NasutionAfiliasi tidak diketahui5
Hamzah ShatriAfiliasi tidak diketahui5
Muhammad YaminInstitut Agama Islam Negeri Bone4
Siti SetiatiAfiliasi tidak diketahui4
Yulianto YuliantoAfiliasi tidak diketahui3
Rudi PutrantoAfiliasi tidak diketahui3
Annisa Puspitasari NachrowiAfiliasi tidak diketahui3
Evy YunihastutiAfiliasi tidak diketahui3
Alvina WidhaniAfiliasi tidak diketahui3
Pringgodigdo NugrohoAfiliasi tidak diketahui3
Parlindungan SiregarAfiliasi tidak diketahui2
Ginova NainggolanAfiliasi tidak diketahui2
Ika Prasetya WijayaAfiliasi tidak diketahui2
Zahra Nuril AnwarAfiliasi tidak diketahui2
Anshari Saifuddin HasibuanAfiliasi tidak diketahui2
Sukamto KoesnoeAfiliasi tidak diketahui2
Aida LydiaAfiliasi tidak diketahui2
Taufik IndrajayaAfiliasi tidak diketahui2
Ikhwan RinaldiAfiliasi tidak diketahui2
Rudy HidayatAfiliasi tidak diketahui2
Irsan HasanAfiliasi tidak diketahui2
Lugyanti SukrismanAfiliasi tidak diketahui2
Nurul Inayah RahmaniAfiliasi tidak diketahui2
Em YunirUniversity of Indonesia2
Dyah PurnamasariAfiliasi tidak diketahui1
Ahmad Fariz M.Z ZeinAfiliasi tidak diketahui1
Sally A NasutionAfiliasi tidak diketahui1
Wawan SetyawanAfiliasi tidak diketahui1
Suzanna ImmanuelAfiliasi tidak diketahui1
Arini SetiawatiAfiliasi tidak diketahui1
Muhadi MuhadiAfiliasi tidak diketahui1
Rasco Sandy SihombingAfiliasi tidak diketahui1

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Sumber metadata: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
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	<dc:title xml:lang="en-US">Factors Associated with 30-day Major Adverse Cardiovascular Event in Acute Coronary Syndrome Patients with Non-Dialysis Chronic Kidney Disease: A Retrospective Cohort Study</dc:title>
	<dc:creator>Ginanjar, Eka</dc:creator>
	<dc:creator>Hustrini, Ni Made</dc:creator>
	<dc:creator>Mansjoer, Arif</dc:creator>
	<dc:creator>Al Hanif, M Shiddiq</dc:creator>
	<dc:subject xml:lang="en-US">ACS</dc:subject>
	<dc:subject xml:lang="en-US">CKD</dc:subject>
	<dc:subject xml:lang="en-US">MACE</dc:subject>
	<dc:subject xml:lang="en-US">GRACE score</dc:subject>
	<dc:subject xml:lang="en-US">Gensini score</dc:subject>
	<dc:subject xml:lang="en-US">LVH</dc:subject>
	<dc:subject xml:lang="en-US">NLR</dc:subject>
	<dc:description xml:lang="en-US">Background: Acute coronary syndrome (ACS) accounts for the majority of ischemic heart disease-related deaths. It is known that ACS patients with chronic kidney disease (CKD) tend to have worse clinical outcomes, including major adverse coronary events (MACE) compared to patients without CKD.  Some studies suggested that several determinant factors may be involved in this condition. Until now, research on determinant factors of MACE in ACS patients with CKD in Indonesia is still limited. Thus, we aimed to investigate the relationship of various factors to MACE in ACS patients with non-dialysis CKD who underwent percutaneous coronary intervention (PCI), in the form of neutrophile leukocyte ratio (NLR) as a factor describing chronic inflammation, left ventricular hypertrophy (LVH) as a factor describing cardiac remodeling, Gensini score may represent coronary severity, whereas GRACE was used to evaluate the severity and clinical risk of ACS patients. Methods: This study is a retrospective cohort study using secondary data from the medical records of 117 ACS patients who underwent percutaneous coronary intervention (PCI) at Cipto Mangunkusumo General Hospital Jakarta from January 2018 to June 2018 . Patients were classified based on the stage of CKD and assessed for 30-day MACE. Data were recorded on GRACE score, Gensini score, LVH, and neutrophil-lymphocyte ratio (NLR). Analysis of the relationship between these factors was carried out using the chi-square test. Results: Of the 117 patients, 62.3% were STEMI. At the end of hospital treatment, 67.5% were in the normal-stage 2 CKD group, 17.1% in the CKD stage 3a-3b group, and 15.4% in the CKD stage 4-5 group. MACE occurred in 47 (40.2%) patients with 17 (14.5%) dying. There was a significant relationship between GRACE scores and MACE (54.8% MACE at high GRACE scores vs. 32% MACE at low-moderate GRACE scores, p = 0.016, OR: 2,57 CI 95%, 1,18-5,59), while no significant relationship was found for the Gensini score, LVH, and NLR scores even though there was an increase in the proportion of MACE. Conclusion: The incidence of MACE is higher than in the previous studies conducted in the same place, i.e. Cipto Mangunkusumo General Hospital, no significant relationship is found in NLR, LVH, and Gensini score with the 30-day MACE of ACS patients with non-dialysis CKD, meanwhile the GRACE score correlates with the 30-day MACE of ACS in non-dialysis CKD patients as is the known theory regarding this score.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2023-03-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2170</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 55 No. 1 (2023): Acta Medica Indonesiana; 10</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2170/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2023 Eka Ginanjar, Ni Made Hustrini, Arif Mansjoer, M. Shiddiq Al Hanif</dc:rights>
</oai_dc:dc>