open access

Vol 65, No 6 (2007)
Other
Published online: 2007-07-02
Submitted: 2012-12-28
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Original article
Risk stratification according to the type of impaired renal function in patients with acute myocardial infarction treated with percutaneous coronary intervention

Jacek Kowalczyk, Radosław Lenarczyk, Oskar Kowalski, Andrzej Świątkowski, Joanna Stabryła-Deska, Tomasz Kurek, Grzegorz Honisz, Tomasz Kukulski, Mariusz Gąsior, Zbigniew Kalarus
Kardiol Pol 2007;65(6):635-643.

open access

Vol 65, No 6 (2007)
Other
Published online: 2007-07-02
Submitted: 2012-12-28

Abstract

Background: It has been shown that successful reperfusion improves in-hospital and long-term outcome of patients with acute myocardial infarction (AMI). Nevertheless, some patients are still at high risk due to AMI despite achievement of reperfusion. Impaired renal function (IRF) is one of the recently recognised risk factors in this population. However, the prognostic value of different types of IRF in patients with AMI treated with percutaneous coronary intervention (PCI) has not been well characterised. Aim: To evaluate the prognostic value of different types of IRF in AMI patients treated with PCI. Methods: The single centre AMI registry encompassed 1486 consecutive AMI patients treated with PCI, who were followed for a mean of 29.7 months. Subjects with at least 1 measurement of serum creatinine >133 µmol/l (>1.5 mg/dl) during hospitalisation were selected (n=194; 13.1%) and incorporated into the IRF group. The control group consisted of 1292 (86.9%) subjects with normal renal function. The IRF patients were divided into subgroups: contrast-induced nephropathy – CIN (n=90; 6.1%); and chronic kidney disease – CKD (n=66; 4.4%). Thirty-eight patients from the IRF group (2.6%) had normal value of serum creatinine on admission and did not match criteria of CIN. Patients with creatinine value >133 µmol/l on admission were incorporated into the CKD group. CIN was defined as a serum creatinine level 133 µmol/l within 48 hours after PCI. Among CIN patients 2 subgroups were identified with respect to coexisting diabetes mellitus: CIN-DM and CIN-nDM (both n=45; 3.05%). Results: Remote mortality rate was significantly higher in the IRF group (38.7%) and in particular subgroups – CKD (51.5%), CIN-DM (46.7%), CIN-nDM (28.9%) – than in controls (10.3%, p

Abstract

Background: It has been shown that successful reperfusion improves in-hospital and long-term outcome of patients with acute myocardial infarction (AMI). Nevertheless, some patients are still at high risk due to AMI despite achievement of reperfusion. Impaired renal function (IRF) is one of the recently recognised risk factors in this population. However, the prognostic value of different types of IRF in patients with AMI treated with percutaneous coronary intervention (PCI) has not been well characterised. Aim: To evaluate the prognostic value of different types of IRF in AMI patients treated with PCI. Methods: The single centre AMI registry encompassed 1486 consecutive AMI patients treated with PCI, who were followed for a mean of 29.7 months. Subjects with at least 1 measurement of serum creatinine >133 µmol/l (>1.5 mg/dl) during hospitalisation were selected (n=194; 13.1%) and incorporated into the IRF group. The control group consisted of 1292 (86.9%) subjects with normal renal function. The IRF patients were divided into subgroups: contrast-induced nephropathy – CIN (n=90; 6.1%); and chronic kidney disease – CKD (n=66; 4.4%). Thirty-eight patients from the IRF group (2.6%) had normal value of serum creatinine on admission and did not match criteria of CIN. Patients with creatinine value >133 µmol/l on admission were incorporated into the CKD group. CIN was defined as a serum creatinine level 133 µmol/l within 48 hours after PCI. Among CIN patients 2 subgroups were identified with respect to coexisting diabetes mellitus: CIN-DM and CIN-nDM (both n=45; 3.05%). Results: Remote mortality rate was significantly higher in the IRF group (38.7%) and in particular subgroups – CKD (51.5%), CIN-DM (46.7%), CIN-nDM (28.9%) – than in controls (10.3%, p
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Keywords

myocardial infarction (MI); percutaneous coronary intervention (PCI); renal impairment; contrast-induced nephropathy; diabetes

About this article
Title

Original article
Risk stratification according to the type of impaired renal function in patients with acute myocardial infarction treated with percutaneous coronary intervention

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 65, No 6 (2007)

Pages

635-643

Published online

2007-07-02

Bibliographic record

Kardiol Pol 2007;65(6):635-643.

Keywords

myocardial infarction (MI)
percutaneous coronary intervention (PCI)
renal impairment
contrast-induced nephropathy
diabetes

Authors

Jacek Kowalczyk
Radosław Lenarczyk
Oskar Kowalski
Andrzej Świątkowski
Joanna Stabryła-Deska
Tomasz Kurek
Grzegorz Honisz
Tomasz Kukulski
Mariusz Gąsior
Zbigniew Kalarus

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