Association of Age and CKD with Prognosis of Myocardial Infarction

Title
Association of Age and CKD with Prognosis of Myocardial Infarction
Author(s)
김영조최준석[최준석]김민지[김민지]강용운[강용운]김창성[김창성]배은희[배은희]마성관[마성관]조명찬[조명찬]김수완[김수완]정명호[정명호]
Keywords
CHRONIC KIDNEY-DISEASE; GLOMERULAR-FILTRATION-RATE; ACUTE CORONARY SYNDROMES; CARDIOVASCULAR OUTCOMES; MORTALITY RISK; REGISTRY; GFR
Issue Date
201306
Publisher
AMER SOC NEPHROLOGY
Citation
CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, v.8, no.6, pp.939 - 944
Abstract
Background and objectives CKD is a well known poor prognostic factor in myocardial infarction (MI). This study evaluated the prognostic significance of CKD, particularly in association with increasing age, in MI patients. Design, setting, participants, & measurements This study was based on a retrospective cohort, the Korean Acute Myocardial Infarction Registry. Patients with a discharge diagnosis of MI were analyzed to investigate the association of CKD with mortality risk according to age. A total of 11,268 patients (mean age 63.0 +/- 12.6 years) were included and followed for 1 year. Results In the full cohort, 26% of patients had CKD (n=2929). The prevalence of CKD was higher with advancing age. Eight hundred sixty-one patients (7.6%) died and the interaction for 1-year mortality between age strata and estimated GFR (eGFR) strata was significant (P<0.001). Within each age category, the absolute 1-year mortality was higher in patients with a low eGFR. However, the adjusted relative mortality risk for a low eGFR was lower with increasing age (adjusted hazard ratio [95% confidence interval] for 1-year mortality at eGFR <30 ml/min per 1.73 m(2): 4.84 [1.93-12.15], 4.53 [2.42-8.47], 3.51 [2.42-5.09], and 3.30 [2.41-4.52] for patients aged <55, 55-64, 65-74, and >= 75 years compared with those with eGFR >= 60 ml/min per 1.73 m(2), respectively). Conclusions For all age categories, the overall mortality was significantly higher as eGFR declined. The association of a lower eGFR with mortality was weaker with increasing age, indicating that the prognostic significance of CKD in MI patients is age dependent.
URI
http://hdl.handle.net/YU.REPOSITORY/29861http://dx.doi.org/10.2215/CJN.06930712
ISSN
1555-9041
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의과대학 > 내과학교실 > Articles
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