PB0051 - Rapid eGFRcys Decline Closely Correlates With Episodes of Acute Coronary Syndrome in Asian Patients with Type 2 Diabetes

Background: Cystatin C-based equation to estimate glomerular filtration rate (eGFRcys, mL/min/1.73m2) can detect renal dysfunction earlier as compared to creatinine-based equation estimate (eGFRcreat). Both impaired renal function and type 2 diabetes predispose patients to acute coronary syndrome (ACS). Thrombosis plays a crucial role in ACS pathology.

Aims: Thus, we evaluated the correlation between eGFRcys, eGFRcreat and ACS in Asian type 2 diabetes patients.

Methods: In type 2 diabetes patients who were hospitalized with a diagnosis of ACS (n=158), eGFRcys and eGFRcreat were retrospectively calculated over the past 5 years and their association with ACS was examined using receiver operating characteristic (ROC) analysis.

Results: eGFRcys was associated with episodes of ACS (P=0.041) and eGFRcreat exhibited no correlation with episode of ACS (P=0.261). Discrepancy between eGFRcys and eGFRcreat ( < 9) correlated significantly with episodes of ACS and area under the curve of ROC was 0.653 (P=0.001). Rapid decline of eGFRcys in the past 5 years over 10 correlated significantly with episode of ACS (AUC=0.665, P=0.001). In contrast, decline of eGFRcreat did not correlate with ACS (AUC=0.569, P=0.149).

Conclusion(s): These results suggest that both (1) discrepancy between eGFRcys and eGFRcreat, and (2) rapid decline in eGFRcys effectively display an elevated risk of ACS episodes in diabetes. Serial measurement of cystatin C and impaired renal function monitored by rapid decline in eGFRcys can potentially predict ACS episodes in Asian diabetic patients.