title: [The impact of chronic kidney disease on in-hospital clinical outcomes in patients undergoing primary percutaneous angioplasty for ST-segment elevation myocardial infarction].
abstract: OBJECTIVE
  We investigated the effect of chronic kidney disease (CKD) on in-hospital results in patients undergoing primary percutaneous angioplasty for ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  The study included 2,486 patients (2,070 men, 416 women) who were treated with primary angioplasty for STEMI. Of these, 273 patients (11%) were found to have CKD (glomerular filtration rate <60 ml/min/1.73 m2) before the procedure. Patients with and without CKD were evaluated with respect to demographic and clinical features, primary angioplasty findings, and in-hospital clinical results.
  
  
  RESULTS
  Patients with CKD exhibited a higher mean age, Killip class, and higher frequencies of female gender, diabetes, hypertension, anemia, and previous myocardial infarction (p<0.05). Angioplasty showed higher rates of right coronary artery lesion, multivessel disease, contrast nephropathy, unsuccessful procedure, and increased stenosis rate and stent length in CKD patients (p<0.05). Cardiovascular mortality occurred in 11.7% and 1.4% of patients with and without CKD, respectively (p<0.001). Patients with CKD had significantly higher incidences of target vessel revascularization, major cardiac events, stroke, cardiopulmonary resuscitation, hemodialysis, ventricular tachycardia/fibrillation, severe heart failure, cardiogenic shock, and significant hemorrhage (p<0.05). Multivariate analysis showed that CKD was an independent predictor of mortality (OR=4.1, 95% CI 1.83-9.17; p=0.001).
  
  
  CONCLUSIONS
  Our findings show that CKD patients undergoing primary angioplasty for STEMI have an increased risk profile and poorer in-hospital results, and that CKD represents an independent risk factor for mortality.
authors.affiliation: Department of Cardiology, Siyami Ersek Cardiovascular Surgery Center, İstanbul, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Akkaya
authors.forename: Erkan
authors.initials: E
authors.lastname: Ayhan
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Mehmet
authors.initials: M
authors.lastname: Ergelen
authors.forename: Ayça
authors.initials: A
authors.lastname: Türer
authors.forename: Deniz
authors.initials: D
authors.lastname: Demirci
authors.forename: Duygu
authors.initials: D
authors.lastname: Demirci
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ciçek
authors.forename: Mehmet
authors.initials: M
authors.lastname: Gül
authors.forename: Zeki
authors.initials: Z
authors.lastname: Günaydın
authors.forename: Ahmet
authors.initials: A
authors.lastname: Narin
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D001145:Arrhythmias, Cardiac / Q000150:complications; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012307:Risk Factors; D012737:Sex Factors; D016896:Treatment Outcome; D014421:Turkey / Q000453:epidemiology