Serum creatinine on admission predicts long-term mortality in acute myocardial infarction patients undergoing successful primary angioplasty: data from the Heart Institute of Japan Acute Myocardial Infarction (HIJAMI) Registry.
BACKGROUND
Data about the long-term mortality of acute myocardial infarction (AMI) patients with renal insufficiency who received sufficient early revascularization are scant, so the present study evaluated the impact of serum creatinine levels on the long-term mortality in patients with AMI undergoing successful primary percutaneous coronary intervention (PCI).


RESULTS
The Heart Institute of Japan Acute Myocardial Infarction (HIJAMI) registry has 3,021 consecutive AMI patients. Primary PCI was attempted in 1,451 patients and successful revascularization was obtained in 1,359 patients (93.6%). An elevated serum creatinine level, defined as creatinine > or =1.2 mg/dl, was observed in 216 patients (15.8%). Univariate analyses showed statistical differences between normal and elevated serum creatinine groups in age, gender, hypertension, previous myocardial infarction, number of diseased vessels and Killip class. During a median follow-up period of 39 [32-49] months, the event-free survival rate was lower in elevated creatinine group than normal creatinine group. Multivariate Cox proportional hazards model showed that serum creatinine level was an independent predictor of long-term mortality (adjusted hazard ratio 1.43 [95% confidence interval 1.03-1.99]).


CONCLUSIONS
The serum creatinine level on admission in patients with AMI predicts long-term mortality, even in those with successful primary PCI.
Yamaguchi
Junichi
J
Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, Tokyo, Japan. junichi.yamaguchi@nifty.com
Kasanuki
Hiroshi
H
Ishii
Yasuhiro
Y
Yagi
Masahiro
M
Nagashima
Michitaka
M
Fujii
Shinya
S
Koyanagi
Ryo
R
Ogawa
Hiroshi
H
Hagiwara
Nobuhisa
N
Haze
Kazuo
K
Sumiyoshi
Tetsuya
T
Honda
Takashi
T
D000047:Academies and Institutes; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D003404:Creatinine / Q000097:blood*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000401:mortality / Q000628:therapy; D007564:Japan; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality* / Q000628:therapy*; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013997:Time Factors
D003404:Creatinine