Decreased Glomerular Filtration Rate is an Independent Predictor of In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.
10.4070/kcj.2011.41.4.184
- Author:
Joon Young KIM
1
;
Myung Ho JEONG
;
Yong Keun AHN
;
Jae Hyun MOON
;
Shung Chull CHAE
;
Seung Ho HUR
;
Taek Jong HONG
;
Young Jo KIM
;
In Whan SEONG
;
In Ho CHAE
;
Myeong Chan CHO
;
Chong Jin KIM
;
Yang Soo JANG
;
Junghan YOON
;
Ki Bae SEUNG
;
Seung Jung PARK
Author Information
1. St. Carollo Hospital, Suncheon, Korea.
- Publication Type:Original Article
- Keywords:
Glomerular filtration rate;
Acute myocardial infarction;
Mortality;
Percutaneous coronary intervention
- MeSH:
Arteries;
C-Reactive Protein;
Creatine;
Glomerular Filtration Rate;
Heart Failure;
Heart Ventricles;
Hospital Mortality;
Humans;
Hypertension;
Korea;
Logistic Models;
Myocardial Infarction;
Natriuretic Peptide, Brain;
Odds Ratio;
Percutaneous Coronary Intervention;
Prognosis;
Retrospective Studies
- From:Korean Circulation Journal
2011;41(4):184-190
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: Patients with renal dysfunction (RD) experience worse prognosis after myocardial infarction (MI). The aim of the present study was to investigate the impact of admission estimated glomerular filtration rate (eGFR) on clinical outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation MI (STEMI). SUBJECTS AND METHODS: We retrospectively evaluated 4,542 eligible patients from the Korea Acute Myocardial Infarction Registry (KAMIR). Patients were divided into three groups according to eGFR (mL/min/1.73 m2): normal renal function (RF) group (eGFR > or =60, n=3,515), moderate RD group (eGFR between 30 to 59, n=894) and severe RD group (eGFR <30, n=133). Baseline characteristics, angiographic and procedural results, and in-hospital outcomes between the three groups were compared. RESULTS: Age, gender, Killip class > or =3, hypertension, diabetes, congestive heart failure, peak creatine kinase-MB, high sensitivity C-reactive protein, B-type natriuretic peptide, left ventricle ejection fraction, multivessel disease, infarct-related artery and rate of successful PCI were significantly different between the 3 groups (p<0.05). With decline in RF, in-hospital complications developed with an increasing frequency (14.1% vs. 31.8% vs. 45.5%, p<0.0001). In-hospital mortality rate was significantly higher in the moderate and severe RD groups as compared to the normal RF group (2.3% vs. 13.9% vs. 25.6%, p<0.0001). Using multivariate logistic regression analysis, adjusted odds ratio for in-hospital mortality was 2.67 {95% confidence interval (CI) 1.44-4.93, p=0.002} in the moderate RD group, and 4.09 (95% CI 1.48-11.28, p=0.006) in the severe RD group as compared to the normal RF group. CONCLUSION: Decreased admission eGFR was associated with worse clinical courses and it was an independent predictor of in-hospital mortality in STEMI patients undergoing primary PCI.
