Scoping Review of Predictors and Risk Factors for Acute Myocardial Infarction in Patients with Chronic Kidney Disease
Keywords:
Chronic Kidney Disease; Myocardial Infarction; Predictors; Biomarkers; Risk Scores; Dyslipidemia; InflammationAbstract
Background: Chronic kidney disease (CKD) significantly elevates the risk of acute myocardial infarction (AMI) and associated mortality, with cardiovascular disease accounting for approximately 40% of deaths in CKD patients. Diagnostic and therapeutic challenges arise due to altered biomarker profiles and underutilization of interventions like percutaneous coronary intervention (PCI). This systematic review aims to identify and evaluate predictors of AMI in CKD patients, focusing on clinical, biochemical, demographic, and lifestyle-related risk factors to inform targeted prevention strategies. Materials and Methods: Following PRISMA guidelines, a systematic search was conducted across PubMed, Embase, Scopus, Web of Science, and Cochrane Library up to August 14, 2025, using MeSH terms like “chronic kidney disease” and “myocardial infarction.” Included studies involved adult CKD patients, assessing predictors through observational designs or relevant randomized controlled trial subgroup analyses. Data were extracted by two independent reviewers, with study quality assessed using the Newcastle-Ottawa Scale. Narrative synthesis was employed due to heterogeneity. Results: Twenty studies (54–911,360 participants) identified dyslipidemia, inflammatory (CRP, IL-6) and cardiac biomarkers (NT-proBNP, hs-cTnT), lower eGFR, albuminuria, advanced CKD stage, hypertension, prior AMI, and older age as key AMI predictors. Risk scores (GRACE, PRECISE-DAPT) and novel indices (TyG, TyG-BMI) showed high predictive accuracy. Conclusion: Comprehensive risk assessment integrating biomarkers, clinical factors, and novel indices can enhance AMI prediction and guide interventions in CKD patients, addressing therapeutic underutilization.
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