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: OBJECTIVE
  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).
  
  
  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 m(2)): 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.
  
  
  CONCLUSIONS
  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.
authors: St. Carollo Hospital, Suncheon, Korea.
authors: Joon Young
authors: JY
authors: Kim
authors: Myung Ho
authors: MH
authors: Jeong
authors: Yong Keun
authors: YK
authors: Ahn
authors: Jae Hyun
authors: JH
authors: Moon
authors: Shung Chull
authors: SC
authors: Chae
authors: Seung Ho
authors: SH
authors: Hur
authors: Taek Jong
authors: TJ
authors: Hong
authors: Young Jo
authors: YJ
authors: Kim
authors: In Whan
authors: IW
authors: Seong
authors: In Ho
authors: IH
authors: Chae
authors: Myeong Chan
authors: MC
authors: Cho
authors: Chong Jin
authors: CJ
authors: Kim
authors: Yang Soo
authors: YS
authors: Jang
authors: Junghan
authors: J
authors: Yoon
authors: Ki Bae
authors: KB
authors: Seung
authors: Seung Jung
authors: SJ
authors: Park
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