Abstract | BACKGROUND: METHODS: We analyzed 443 patients diagnosed with AMI who underwent primary PCI. Based on their estimated glomerular filtration rate (eGFR), they were classified into two groups: a high eGFR group (eGFR ≥ 45 mL/min/1.73 m2, n = 381) and a low eGFR group (eGFR < 45 mL/min/1.73 m2, n = 63). WRF was defined as an increase in serum creatinine levels ≥ 0.3 mg/dL above the admission value during the course of hospitalization. The primary end-point was set as all-cause mortality. RESULTS: WRF was observed in 88 patients (19.8%). The median follow-up duration was 769 (interquartile range 397-1314) days. The all-cause mortality rate was significantly lower in the high eGFR than in the low eGFR group (5.5 vs. 28.6%, respectively, at 1500 days, P < 0.001). In patients with WRF, the all-cause and cardiac mortality rates were significantly higher than in patients without WRF, and these results were consistent between the high and low eGFR sub-groups. Multivariate Cox proportional hazards model analysis showed that low eGFR and WRF remained independent predictors of all-cause mortality [(hazard ratio 2.61, 95% confidence interval 1.27-5.36, P = 0.009) and (hazard ratio 2.59, 95% confidence interval 1.34-5.01, P = 0.005), respectively]. CONCLUSIONS: Both eGFR at baseline and WRF were observed to be important predictors of mortality in patients with AMI undergoing primary PCI. WRF showed a significant effect on mortality even in patients with high eGFR.
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Authors | Toshijiro Aoki, Hideki Ishii, Akihito Tanaka, Susumu Suzuki, Satoshi Ichimiya, Masaaki Kanashiro, Toyoaki Murohara |
Journal | Clinical and experimental nephrology
(Clin Exp Nephrol)
Vol. 23
Issue 2
Pg. 182-188
(Feb 2019)
ISSN: 1437-7799 [Electronic] Japan |
PMID | 30218297
(Publication Type: Journal Article, Observational Study)
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Topics |
- Aged
- Aged, 80 and over
- Cohort Studies
- Female
- Humans
- Japan
(epidemiology)
- Male
- Middle Aged
- Myocardial Infarction
(complications, therapy)
- Percutaneous Coronary Intervention
(mortality)
- Renal Insufficiency, Chronic
(complications)
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