Management of chronic coronary disease and acute coronary syndromes in patients with chronic kidney disease

Abstract

Abstract coronary atherosclerosis is accelerated and highly prevalent among patients with chronic kidney disease (CKD). Acute coronary syndromes (ACS) are common in CKD and are a major source of morbidity and mortality in this population. The management of chronic coronary disease and ACS includes anti-ischemic agents, antiplatelet medications, anticoagulants, and medications that modify the natural history of myocardial remodeling after injury. In addition, revascularization, primarily with catheter-based techniques, is critical for optimal outcomes in moderate- and higher-risk patients. This article will review the array of treatments used in combination for stable coronary disease and ACS and will provide critical guidance concerning benefits, risks, and dose adjustments required for patients with baseline CKD.