Management of Acute Coronary Syndromes in Patients with Renal Insufficiency

摘要

Chronic kidney disease (CKD) is highly prevalent in patients with acute coronary syndromes (ACS) and isnassociated with poor outcomes. The clinical management of patients with CKD who develop ACS is problematic becausenof the lack of well-designed randomized trials assessing therapeutic strategies in such patients. The almost uniformnexclusion of patients with CKD from randomized studies evaluating new targeted therapies for ACS, and concern aboutnfurther deterioration of renal function and therapy-related toxic effects, may explain the less frequent use of provennmedical therapies in this subgroup of high-risk patients. This could contribute to their excessive mortality. The objectivenof this review is to discuss the unresolved issues and uncertainties regarding recommended medical therapies andninterventional strategies in CKD patients who develop an ACS.