Rapid decline in renal function after acute myocardial infarction.
OBJECTIVE
To investigate the long term effects of cardiac events on renal function, a prospective study of patients with acute myocardial infarction was conducted.


METHODS
A total of 137 patients with acute myocardial infarction were followed for 1 year. The change of estimated glomerular filtration rate (eGFR) in cardiac patients was compared with that in background-matched controls, and the factors associated with eGFR changes were analyzed.


RESULTS
The eGFR decrease was much larger after myocardial infarction, from 73.7 ± 1.9 ml/min/1.73 m2 (mean ± SEM) at baseline to 64.7 ± 1.7 at 1 year, (p < 0.001), compared with that of controls (from 72.8 ± 1.2 to 72.1 ± 1.3, p = 0.305). Multiple regression analysis showed that eGFR change was associated negatively with age, baseline eGFR, proteinuria, and positively with the administration of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers, but not the severity of cardiac damage and comorbidities. Longitudinal analysis 1 year before and 2 years after myocardial infarction showed that eGFR decrease was larger during baseline and 6 months after the event (-7.0 ± 1.0).


CONCLUSIONS
Renal decline was rapid after myocardial infarction and was affected by clinical characteristics of patients. Careful follow-up of renal function is recommended to prevent the progression of renal and cardiac disease.
Department of Cardiology, Yamagata University School of Medicine, Yamagata, Japan.
Yusuke
Y
Mashima
Tsuneo
T
Konta
Kazunobu
K
Ichikawa
Ami
A
Ikeda
Kazuko
K
Suzuki
Masahiro
M
Wanezaki
Satoshi
S
Nishiyama
Tetsu
T
Watanabe
Isao
I
Kubota
D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000503:physiopathology; D011379:Prognosis; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000209:etiology / Q000503:physiopathology*; D012307:Risk Factors