ArticleReviews in cardiovascular medicine2025
Renal Dysfunction, Coronary Artery Lesion Complexity, and Adverse Cardiovascular Outcomes in Patients With Acute Coronary Syndrome.
Article in Reviews in cardiovascular medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed.
- The Dilemma of Renal Dysfunction and Coronary Artery Revascularization: Insights From Observational Studies.JACC. Asia · 2026Article
- Long-Term Clinical Outcomes of PCI Versus Medical Therapy in NSTEMI Patients with Prior CABG.Medicina (Kaunas, Lithuania) · 2026Article
- Unsupervised cardiometabolic phenotyping unmasks residual MACCE risk beyond LDL-C in acute myocardial infarction after revascularization.Frontiers in cardiovascular medicine · 2026Article
- Diagnostic model for angiographic obstructive coronary artery disease combining CHG, DELC, and traditional risk factors: a bootstrap validation study.Frontiers in endocrinology · 2026Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Renal dysfunction is linked to both the complexity of coronary artery lesions and the prognosis of acute coronary syndrome (ACS). However, the nature of this intricate relationship remains unclear. Therefore, this study aimed to investigate the mechanisms through which coronary lesion complexity mediates the association between renal dysfunction and adverse cardiovascular outcomes in patients with ACS. Methods: This analysis included 1400 ACS patients who underwent percutaneous coronary intervention (PCI). Renal function was assessed using the estimated glomerular filtration rate (eGFR), calculated according to the 2021 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, which incorporates both creatinine and cystatin C. Coronary lesion complexity was evaluated using the baseline SYNTAX score (bSS). The associations among eGFR, bSS, and major adverse cardiovascular events (MACEs) were examined using survival analysis, restricted cubic spline (RCS) analysis, and mediation analysis. Results: A total of 229 MACEs (16.4%) occurred over a median follow-up of 31.03 (27.34, 35.06) months, including 99 all-cause deaths (7.0%), 41 myocardial infarctions (2.9%), and 123 unplanned revascularizations (8.9%). After multivariate adjustment, both the eGFR and bSS significantly predicted MACEs across the total population and various subgroups. Mediation analysis showed that bSS mediated 16.49%, 14.76%, 12.87%, and 11.95% of the correlation between eGFR and MACEs in different adjusted models. Conclusion: The relationship between renal dysfunction and MACEs in ACS patients is partially mediated by coronary lesion complexity. This finding underscores the importance of integrating kidney function assessments with coronary anatomical evaluations to develop individualized risk stratification strategies.
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