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

Joon Young Kim, Myung Ho Jeong, Yong Keun Ahn, Jae Hyun Moon, Shung Chull Chae, Seung Ho Hur, Taek Jong Hong, Young Jo Kim, In Whan Seong, In Ho Chae, Myeong Chan Cho, Chong Jin Kim, Yangsoo Jang, Junghan Yoon, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

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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.

Original languageEnglish
Pages (from-to)184-190
Number of pages7
JournalKorean Circulation Journal
Volume41
Issue number4
DOIs
Publication statusPublished - 2011 Apr 1

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Percutaneous Coronary Intervention
Hospital Mortality
Glomerular Filtration Rate
Kidney
Myocardial Infarction
ST Elevation Myocardial Infarction
Confidence Intervals
MB Form Creatine Kinase
Brain Natriuretic Peptide
Korea
C-Reactive Protein
Heart Ventricles
Registries
Heart Failure
Arteries
Logistic Models
Odds Ratio
Regression Analysis
Hypertension
Mortality

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Joon Young ; Jeong, Myung Ho ; Ahn, Yong Keun ; Moon, Jae Hyun ; Chae, Shung Chull ; Hur, Seung Ho ; Hong, Taek Jong ; Kim, Young Jo ; Seong, In Whan ; Chae, In Ho ; Cho, Myeong Chan ; Kim, Chong Jin ; Jang, Yangsoo ; Yoon, Junghan ; Seung, Ki Bae ; Park, Seung Jung. / 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. In: Korean Circulation Journal. 2011 ; Vol. 41, No. 4. pp. 184-190.
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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",
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.",
author = "Kim, {Joon Young} and Jeong, {Myung Ho} and Ahn, {Yong Keun} and Moon, {Jae Hyun} and Chae, {Shung Chull} and Hur, {Seung Ho} and Hong, {Taek Jong} and Kim, {Young Jo} and Seong, {In Whan} and Chae, {In Ho} and Cho, {Myeong Chan} and Kim, {Chong Jin} and Yangsoo Jang and Junghan Yoon and Seung, {Ki Bae} and Park, {Seung Jung}",
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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. / Kim, Joon Young; Jeong, Myung Ho; Ahn, Yong Keun; Moon, Jae Hyun; Chae, Shung Chull; Hur, Seung Ho; Hong, Taek Jong; Kim, Young Jo; Seong, In Whan; Chae, In Ho; Cho, Myeong Chan; Kim, Chong Jin; Jang, Yangsoo; Yoon, Junghan; Seung, Ki Bae; Park, Seung Jung.

In: Korean Circulation Journal, Vol. 41, No. 4, 01.04.2011, p. 184-190.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

AU - Kim, Joon Young

AU - Jeong, Myung Ho

AU - Ahn, Yong Keun

AU - Moon, Jae Hyun

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Hong, Taek Jong

AU - Kim, Young Jo

AU - Seong, In Whan

AU - Chae, In Ho

AU - Cho, Myeong Chan

AU - Kim, Chong Jin

AU - Jang, Yangsoo

AU - Yoon, Junghan

AU - Seung, Ki Bae

AU - Park, Seung Jung

PY - 2011/4/1

Y1 - 2011/4/1

N2 - 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.

AB - 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.

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