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

Title
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
Author(s)
김영조김준영[김준영]정명호[정명호]안용근[안용근]문재현[문재현]채성철[채성철]허승호[허승호]홍택종[홍택종]성인환[성인환]채인호[채인호]조명찬[조명찬]김종진[김종진]장양수[장양수]윤정한[윤정한]승기배[승기배]박승정[박승정]
Keywords
Glomerular filtration rate; Acute myocardial infarction; Mortality; Percutaneous coronary intervention.
Issue Date
201105
Publisher
대한심장학회
Citation
Korean Circulation Journal, v.41, no.4, pp.184 - 190
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 m^2): normal renal function (RF) group (eGFR ≥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 ≥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.
URI
http://hdl.handle.net/YU.REPOSITORY/25171
ISSN
1738-5520
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의과대학 > 내과학교실 > Articles
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