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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

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Author(s)
Joon Young KimMyung Ho JeongYong Keun AhnJae Hyun MoonShung Chull ChaeSeung Ho HurTaek Jong HongYoung Jo KimIn Whan SeongIn Ho ChaeMyeong Chan ChoChong Jin KimYang Soo JangJunghan YoonKi Bae SeungSeung Jung Park
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Korean Circulation Journal
Issued Date
2011
Volume
41
Issue
4
Keyword
Glomerular filtration rateAcute myocardial infarctionMortalityPercutaneous coronary intervention
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 ≥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.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine
Citation
Joon Young Kim et al. (2011). 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. Korean Circulation Journal, 41(4), 184–190. doi: 10.4070/kcj.2011.41.4.184
Type
Article
ISSN
1738-5520
DOI
10.4070/kcj.2011.41.4.184
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/36048
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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