title: [Renal function outcome in acute myocardial infarction as a prognostic factor of in-hospital events and at one-year follow-up].
abstract: OBJECTIVE
  To analyze the role of renal dysfunction at admission or during hospitalization in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  Two hundred and seventy-four patients with AMI were assessed between January 2000 and December 2001. Renal function was monitored by serum creatinine (Cr) measurement at admission and peak level during hospitalization. Creatinine clearance (CrCl) was estimated by the Cockcroft-Gault formula. In-hospital and one-year morbidity and mortality were evaluated.
  
  
  RESULTS
  Mean age of the population studied was 62.2 +/- 13.5, and 73% of the patients were male. Renal function was more reduced in male patients and in those with systemic arterial hypertension and prior CABG. Multivariate analysis showed higher hospital mortality rates associated with increased peak serum Cr levels (OR: 1.18 95% CI: 1.18-2.77 p = 0.006), decreased baseline CrCl (OR: 0.96 95% CI: 0.93-0.99 p = 0.025) and peak CrCl (OR: 0.96 95% CI: 0.92-0.99 p = 0.023). Percent difference between baseline CrCl and the lowest CrCl obtained during hospitalization also indicated higher mortality rates (OR: 1.04 95% CI: 1.00-1.07 p = 0.033). No change was observed in the one-year morbidity and mortality from worsening of renal function.
  
  
  CONCLUSIONS
  Renal dysfunction at admission and its deterioration during hospitalization have proved to be a major prognostic marker for immediate poor outcome.
authors.affiliation: Instituto Dante Pazzanese de Cardiologia, São Paulo, SP. espimenta@cardiol.br
authors.forename: Eduardo
authors.initials: E
authors.lastname: Pimenta
authors.forename: Rui Fernando
authors.initials: RF
authors.lastname: Ramos
authors.forename: Carlos
authors.initials: C
authors.lastname: Gun
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Santos
authors.forename: Ari
authors.initials: A
authors.lastname: Timerman
authors.forename: Leopoldo S
authors.initials: LS
authors.lastname: Piegas
mesh_terms: D017677:Age Distribution; D000368:Aged; D003404:Creatinine / Q000097:blood; D004812:Epidemiologic Methods; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D051437:Renal Insufficiency / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology*; D017678:Sex Distribution
chemical_list: D003404:Creatinine