Publication:

Cardiovascular risk and acute coronary syndrome management in chronic kidney disease patients: a prospective observation study

Background Chronic kidney disease (CKD) significantly elevates the risk of coronary artery disease (CAD) due to both traditional and uraemia-related risk factors, leading to accelerated atherosclerosis and increased cardiovascular events. This study aims to evaluate the clinical and therapeutic characteristics of CKD patients with ACS, assess CKD's impact on ACS severity and outcomes and identify effective management strategies for this high-risk group.

Methods This prospective study included 104 ACS patients admitted across various medical centers in Cumilla, Bangladesh between June 2023 and June 2024. Data were collected on demographics, clinical history, diagnostics and therapeutic interventions, with rigorous ethical considerations and informed consent. Statistical analysis was conducted using descriptive statistics to explore the clinical and therapeutic characteristics of ACS in patients with CKD.

Results The study examined a diverse patient group with an average age of 34.2 years, predominantly male (55.8%). Smoking was reported by 26.9%, with hypertension (38.5%) and diabetes (28.8%) being common. LVEF was normal in 50%, mildly reduced in 25% and moderately reduced in 25%. Chest pain was the most common symptom (26.9%). ACS patients with chronic kidney disease had higher complication rates, including reinfarction (27.9%), cerebrovascular events (21.2%) and an in-hospital mortality rate of 14.4%, underscoring the severity of their cardiovascular risks.

Conclusions In conclusion, chronic kidney disease (CKD) markedly amplifies the risk of coronary artery disease (CAD) by combining traditional cardiovascular risk factors with those related to uraemia, resulting in heightened morbidity and mortality.