caa a22 4500 606221069 CHVBK 20210128101127.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00380-014-0504-9 doi (NATIONALLICENCE)springer-10.1007/s00380-014-0504-9 Additive effect of in-hospital TIMI bleeding and chronic kidney disease on 1-year cardiovascular events in patients with acute coronary syndrome [Elektronische Daten] Data from Taiwan Acute Coronary Syndrome Full Spectrum Registry [Tsung-Hsien Lin, Wen-Ter Lai, Chi-Tai Kuo, Juey-Jen Hwang, Fu-Tien Chiang, Shu-Chen Chang, Chee-Jen Chang] In-hospital bleeding (IHB) is associated with the risk of subsequent cardiovascular events (CVE) in acute coronary syndrome (ACS). We investigated whether increased risk of CVE by IHB is influenced by chronic kidney disease (CKD) or both have detrimental effects on CVE. In a Taiwan national-wide registry, 2819 ACS patients were enrolled. CKD is defined as an estimated glomerular filtration rate of <60ml/min per 1.73m2. The primary end point is the composite of death, non-fatal myocardial infarction and non-fatal stroke at 12months. 53 (1.88%) and 949 (33.7%) patients suffered from IHB and CKD, respectively. Both IHB and CKD are independently associated with increased risk of the primary end point (HR 2.04, 95% CI 1.05-3.99, p=0.037 and HR 2.17, 95% CI 1.63-2.87, p<0.01, respectively). The Kaplan-Meier curves show significantly higher event rates among those with IHB and CKD in the whole, ST-elevation and non-ST elevation populations (all p<0.01). Patients with IHB(+)/CKD(−), IHB(−)/CKD(+) and IHB(+)/CKD(+) have 1.88-, 2.13- and 2.98-fold risk to suffer from the primary end point compared with those without IHB and CKD (p=0.23, <0.01 and <0.01, respectively). IHB or CKD is independently associated with poor cardiovascular outcome and patients with both IHB and CKD have the worst outcome in ACS. The Author(s), 2014 Acute coronary syndrome nationallicence Chronic kidney disease nationallicence Bleeding nationallicence CVD : Cardiovascular disease nationallicence ACS : Acute coronary syndrome nationallicence CVE : Cardiovascular events nationallicence PCI : Percutaneous coronary intervention nationallicence CKD : Chronic kidney disease nationallicence IHB : In-hospital bleeding nationallicence TIMI : Thrombolysis in myocardial infarction nationallicence MI : Myocardial infarction nationallicence GFR : Glomerular filtration rate nationallicence ESRD : End-stage renal disease nationallicence MDRD : Modification of diet in renal disease nationallicence STE-ACS : ST-elevation acute coronary syndrome nationallicence DBP : Diastolic blood pressure nationallicence CAD : Coronary artery disease nationallicence CVA : Cerebrovascular accident nationallicence NSTE-ACS : Non-ST-elevation acute coronary syndrome nationallicence Lin Tsung-Hsien Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No.100 Tzyou 1st Road, 80708, Kaohsiung, Taiwan, ROC aut Lai Wen-Ter Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No.100 Tzyou 1st Road, 80708, Kaohsiung, Taiwan, ROC aut Kuo Chi-Tai Chang Gung University College of Medicine, Taoyuan, Taiwan aut Hwang Juey-Jen Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan aut Chiang Fu-Tien Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan aut Chang Shu-Chen Division of Biostatistics, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan aut Chang Chee-Jen Graduate Institute of Clinical Medicine, Research Center for Clinical Informatics and Medical Statistics, Chang Gung University, Taoyuan, Taiwan aut Heart and Vessels Springer Japan 30/4(2015-07-01), 441-450 0910-8327 30:4<441 2015 30 380 https://doi.org/10.1007/s00380-014-0504-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0504-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lin Tsung-Hsien Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No.100 Tzyou 1st Road, 80708, Kaohsiung, Taiwan, ROC aut NATIONALLICENCE 700 1- Lai Wen-Ter Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, No.100 Tzyou 1st Road, 80708, Kaohsiung, Taiwan, ROC aut NATIONALLICENCE 700 1- Kuo Chi-Tai Chang Gung University College of Medicine, Taoyuan, Taiwan aut NATIONALLICENCE 700 1- Hwang Juey-Jen Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan aut NATIONALLICENCE 700 1- Chiang Fu-Tien Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan aut NATIONALLICENCE 700 1- Chang Shu-Chen Division of Biostatistics, Institute of Public Health, National Yang-Ming University, Taipei, Taiwan aut NATIONALLICENCE 700 1- Chang Chee-Jen Graduate Institute of Clinical Medicine, Research Center for Clinical Informatics and Medical Statistics, Chang Gung University, Taoyuan, Taiwan aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/4(2015-07-01), 441-450 0910-8327 30:4<441 2015 30 380