Zhonghua xin xue guan bing za zhi · 2008
[Factors associated with reduced renal function post primary percutaneous coronary intervention in acute myocardial infarction patients with normal baseline serum creatinine level].
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Liu Zhen-yu, Zhang Shu-yang, Shen Zhu-jun, Fan Zhong-jie, Fang Quan, Zhu Wen-ling
Аннотация
OBJECTIVE: To analyze factors associated with reduced renal function post primary percutaneous coronary intervention (PCI) in acute myocardial infarction (AMI) patients with normal baseline serum creatinine level.
METHOD: The clinical and angiographic data of 216 consecutive AMI patients undergoing primary PCI with normal baseline serum creatinine level (< 1.5 mg/dl) were obtained and compared between patients with (n = 32) and without (n = 184) renal function deterioration (increase in serum creatinine > or = 25% from baseline level within 72 hours of primary PCI) post PCI.
RESULTS: The incidence of renal function deterioration was 14.8% (32/216). Patients with age > 75 years (28.1% vs. 14.1%, P = 0.047), congestive heart failure (25.0% vs. 9.2%, P = 0.017), less use of low-molecular weight heparins (84.4% vs. 95.1%, P = 0.039) and beta-blockers (75.0% vs. 95.6%, P = 0.001) as well as angiotensin converting enzyme inhibitors/angiotensin receptor blockers (81.3% vs. 93.5%, P = 0.025) and statins (84.4% vs. 97.3%, P = 0.008) were risk factors for developing renal dysfunction post PCI. Renal function deterioration post PCI was also associated with increased in-hospital mortality (25.0% vs. 2.2%, P < 0.001). Multivariate analysis showed that congestive heart failure was the single independent predictor of renal function deterioration (odds ratio = 3.275, 95% confidence interval 1.275 - 8.408, P = 0.014), while renal function deterioration was the strongest independent predictor of in-hospital death (odds ratio = 10.313, 95% confidence interval 2.569 - 41.402, P = 0.001).
CONCLUSION: Renal function deterioration is a common complication post primary PCI and is associated with higher risk of in-hospital death in AMI patients with normal baseline serum creatinine level.
METHOD: The clinical and angiographic data of 216 consecutive AMI patients undergoing primary PCI with normal baseline serum creatinine level (< 1.5 mg/dl) were obtained and compared between patients with (n = 32) and without (n = 184) renal function deterioration (increase in serum creatinine > or = 25% from baseline level within 72 hours of primary PCI) post PCI.
RESULTS: The incidence of renal function deterioration was 14.8% (32/216). Patients with age > 75 years (28.1% vs. 14.1%, P = 0.047), congestive heart failure (25.0% vs. 9.2%, P = 0.017), less use of low-molecular weight heparins (84.4% vs. 95.1%, P = 0.039) and beta-blockers (75.0% vs. 95.6%, P = 0.001) as well as angiotensin converting enzyme inhibitors/angiotensin receptor blockers (81.3% vs. 93.5%, P = 0.025) and statins (84.4% vs. 97.3%, P = 0.008) were risk factors for developing renal dysfunction post PCI. Renal function deterioration post PCI was also associated with increased in-hospital mortality (25.0% vs. 2.2%, P < 0.001). Multivariate analysis showed that congestive heart failure was the single independent predictor of renal function deterioration (odds ratio = 3.275, 95% confidence interval 1.275 - 8.408, P = 0.014), while renal function deterioration was the strongest independent predictor of in-hospital death (odds ratio = 10.313, 95% confidence interval 2.569 - 41.402, P = 0.001).
CONCLUSION: Renal function deterioration is a common complication post primary PCI and is associated with higher risk of in-hospital death in AMI patients with normal baseline serum creatinine level.