Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome

OBJECTIVES: To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of C...

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Autores: Pimienta González, Raquel, Couto Comba, Patricia, Rodríguez Esteban, Marcos, Alemán Sánchez, José Juan, Hernández Afonso, Julio, Rodríguez Pérez, María del Cristo, Marcelino Rodríguez, Itahisa, Brito Díaz, Buenaventura, Elosua Llanos, Roberto, Cabrera de León, Antonio
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2016
País:España
Institución:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
Repositorio:Recercat. Dipósit de la Recerca de Catalunya
OAI Identifier:oai:recercat.cat:10230/33967
Acceso en línea:http://hdl.handle.net/10230/33967
http://dx.doi.org/10.1371/journal.pone.0167166
Access Level:acceso abierto
Palabra clave:Infart de miocardi -- Mortalitat
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spelling Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary SyndromePimienta González, RaquelCouto Comba, PatriciaRodríguez Esteban, MarcosAlemán Sánchez, José JuanHernández Afonso, JulioRodríguez Pérez, María del CristoMarcelino Rodríguez, ItahisaBrito Díaz, BuenaventuraElosua Llanos, RobertoCabrera de León, AntonioInfart de miocardi -- MortalitatOBJECTIVES: To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of CRS1, and to determine whether the severity of CRS1 worsens the prognosis. METHODS: Follow-up study of 1912 incident cases of ACS for 1 year after discharge. Cox regression models were estimated with time to event (in-hospital death, and readmission or death during the first year after discharge) as the dependent variable. RESULTS: The incidence of CRS1 was 9.2/1000 person-days of hospitalization (95% CI = 8.1-10.5), but these patients accounted for 56.6% (95% CI = 47.4-65.) of all mortality. The positive predictive value of CRS1 was 29.6% (95% CI = 23.9-36.0) for in-hospital death, and 51.4% (95% CI = 44.8-58.0) for readmission or death after discharge. The risk of in-hospital death from CRS1 (RR = 18.3; 95% CI = 6.3-53.2) was greater than the sum of risks associated with either acute heart failure (RR = 7.6; 95% CI = 1.8-31.8) or acute kidney injury (RR = 2.8; 95% CI = 0.9-8.8). The risk of events associated with CRS1 also increased with syndrome severity, reaching a RR of 10.6 (95% CI = 6.2-18.1) for in-hospital death at the highest severity level. CONCLUSIONS: The effect of CRS1 on in-hospital mortality is greater than the sum of the effects associated with each of its components, and it increases with the severity of the syndrome. CRS1 accounted for more than half of all mortality, and its positive predictive value approached 30% in-hospital and 50% after discharge.Public Library of Science (PLoS)201820182016info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/33967http://dx.doi.org/10.1371/journal.pone.0167166reponame:Recercat. Dipósit de la Recerca de Catalunyainstname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)InglésPLoS One. 2016 Dec 1;11(12):e0167166© 2016 Pimienta González et al. This is an open access article distributed under the terms of the https://creativecommons.org/licenses/by/4.0/, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are creditedinfo:eu-repo/semantics/openAccessoai:recercat.cat:10230/339672026-05-29T05:05:01Z
dc.title.none.fl_str_mv Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
title Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
spellingShingle Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
Pimienta González, Raquel
Infart de miocardi -- Mortalitat
title_short Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
title_full Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
title_fullStr Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
title_full_unstemmed Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
title_sort Incidence, Mortality and Positive Predictive Value of Type 1 Cardiorenal Syndrome in Acute Coronary Syndrome
dc.creator.none.fl_str_mv Pimienta González, Raquel
Couto Comba, Patricia
Rodríguez Esteban, Marcos
Alemán Sánchez, José Juan
Hernández Afonso, Julio
Rodríguez Pérez, María del Cristo
Marcelino Rodríguez, Itahisa
Brito Díaz, Buenaventura
Elosua Llanos, Roberto
Cabrera de León, Antonio
author Pimienta González, Raquel
author_facet Pimienta González, Raquel
Couto Comba, Patricia
Rodríguez Esteban, Marcos
Alemán Sánchez, José Juan
Hernández Afonso, Julio
Rodríguez Pérez, María del Cristo
Marcelino Rodríguez, Itahisa
Brito Díaz, Buenaventura
Elosua Llanos, Roberto
Cabrera de León, Antonio
author_role author
author2 Couto Comba, Patricia
Rodríguez Esteban, Marcos
Alemán Sánchez, José Juan
Hernández Afonso, Julio
Rodríguez Pérez, María del Cristo
Marcelino Rodríguez, Itahisa
Brito Díaz, Buenaventura
Elosua Llanos, Roberto
Cabrera de León, Antonio
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Infart de miocardi -- Mortalitat
topic Infart de miocardi -- Mortalitat
description OBJECTIVES: To determine whether the risk of cardiovascular mortality associated with cardiorenal syndrome subtype 1 (CRS1) in patients who were hospitalized for acute coronary syndrome (ACS) was greater than the expected risk based on the sum of its components, to estimate the predictive value of CRS1, and to determine whether the severity of CRS1 worsens the prognosis. METHODS: Follow-up study of 1912 incident cases of ACS for 1 year after discharge. Cox regression models were estimated with time to event (in-hospital death, and readmission or death during the first year after discharge) as the dependent variable. RESULTS: The incidence of CRS1 was 9.2/1000 person-days of hospitalization (95% CI = 8.1-10.5), but these patients accounted for 56.6% (95% CI = 47.4-65.) of all mortality. The positive predictive value of CRS1 was 29.6% (95% CI = 23.9-36.0) for in-hospital death, and 51.4% (95% CI = 44.8-58.0) for readmission or death after discharge. The risk of in-hospital death from CRS1 (RR = 18.3; 95% CI = 6.3-53.2) was greater than the sum of risks associated with either acute heart failure (RR = 7.6; 95% CI = 1.8-31.8) or acute kidney injury (RR = 2.8; 95% CI = 0.9-8.8). The risk of events associated with CRS1 also increased with syndrome severity, reaching a RR of 10.6 (95% CI = 6.2-18.1) for in-hospital death at the highest severity level. CONCLUSIONS: The effect of CRS1 on in-hospital mortality is greater than the sum of the effects associated with each of its components, and it increases with the severity of the syndrome. CRS1 accounted for more than half of all mortality, and its positive predictive value approached 30% in-hospital and 50% after discharge.
publishDate 2016
dc.date.none.fl_str_mv 2016
2018
2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/33967
http://dx.doi.org/10.1371/journal.pone.0167166
url http://hdl.handle.net/10230/33967
http://dx.doi.org/10.1371/journal.pone.0167166
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv PLoS One. 2016 Dec 1;11(12):e0167166
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Public Library of Science (PLoS)
publisher.none.fl_str_mv Public Library of Science (PLoS)
dc.source.none.fl_str_mv reponame:Recercat. Dipósit de la Recerca de Catalunya
instname:Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
instname_str Varias* (Consorci de Biblioteques Universitáries de Catalunya, Centre de Serveis Científics i Acadèmics de Catalunya)
reponame_str Recercat. Dipósit de la Recerca de Catalunya
collection Recercat. Dipósit de la Recerca de Catalunya
repository.name.fl_str_mv
repository.mail.fl_str_mv
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