Acute Kidney Injury (AKI) is a strong predictor of in-hospital adverse outcomes, which is a common complication of acute coronary syndromes (ACS). ACS patients with renal impairment during hospitalization are associated with adverse outcomes like heart failure, cardiogenic shock, arrhythmia, dialysis requirement and mortality. Objective: To compare ACS patients with or without AKI has significant risk of in-hospital adverse outcomes. Methods: This prospective comparative study was conducted in

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... he Department of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, during the period of July 2017 to June 2018. A total of 70 eligible patients were included in this study. Electrocardiography, blood test for serum creatinine (on admission, 12 hours, 48 hours and at the time of discharge), lipid profile, RBS, 2-D echocardiography along with serum troponin, CK MB and electrolytes were done for all patients. Results: It was observed that mean age was 58.0±8.5 years in group A (ACS with AKI) and 55.6±12.3 years in group B (ACS without AKI). Male population was predominant in both the groups (85.7% and 74.2%, respectively). Heart failure was more common in group A than in Group B (74.3% vs 34.2% p=0.001 respectively). Arrhythmia was more common in group A than in Group B (100% vs 74.2% respectively). The mean duration of hospital stay was significantly higher in Group A than in the Group B (9.4±2.3 vs 7.2±0.6; p=0.001) days. Conclusion: This study showed adverse outcomes including longer duration of hospital stays were more common in the patients with AKI (group A) than in the patients without AKI (group B).