Risk factors for Type 1 cardio-renal syndrome after ST-segment elevation myocardial infarction
10.11817/j.issn.1672-7347.2014.04.006
- VernacularTitle:急性ST段上抬型心肌梗死合并1型心肾综合征的危险因素
- Author:
Hongwei PAN
;
Ying GUO
;
Zhaofen ZHENG
;
Jianqiang PENG
;
Yu ZHANG
;
Jin HE
;
Zhengyu LIU
;
Yongjun HU
;
Changlu WANG
- Publication Type:Journal Article
- Keywords:
ST-segment elevation myocardial infarction;
Type 1 cardio-renal syndrome;
percutaneous coronary intervention
- From:
Journal of Central South University(Medical Sciences)
2014;(4):355-360
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) atfer ST-segment elevation myocardial infarction (STEMI). Methods: A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency Results: In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular ifltration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (allP<0.05). Multivariate logistic regression showed that age, history of diabetes, admission systolic blood pressure, Killip classification, reduced left ventricular ejection fraction, reduced eGFR, emergency PCI non-undergo and ACEI/ARB non-use were independent risk factors for CRS1 atfer STEMI. In the 256 patients undergoing emergency PCI, 50 patients (19.5%) had CRS1. hTe door-ball time and the amount of contrast agent in the CRS1 group were signiifcantly higher than those in the non- CRS1 group (bothP<0.05), but there was no signiifcant difference in the blood lfow in the “culprit vessel”atfer the PCI (P>0.05). Conclusion: CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.
