title: Renal function and anaemia in acute myocardial infarction.
abstract: BACKGROUND
  Impaired renal function and anaemia are common among patients with acute myocardial infarction (AMI). While both conditions are known independent risk factors for increased mortality, their interaction as risk factors for increased mortality in AMI is unclear.
  
  
  METHODS
  We studied 5395 subjects hospitalized for AMI between January 2000 and December 2005. An estimated glomerular filtration rate (GFR) <60 mL/min/1.73 m(2) was defined as impaired GFR and GFR ≥ 60 mL/min/1.73 m(2) was defined as preserved GFR. Anaemia was defined as <13 g/dL (males) and <12 g/dL (females). The odds ratio (OR) for one-year mortality and its 95% confidence interval (CI) were calculated by logistic regression.
  
  
  RESULTS
  We identified 758 (14%) patients with impaired GFR and anaemia, 1105 (20.5%) patients with impaired GFR without anaemia, 465 (8.6%) patients with preserved GFR and anaemia, and 3012 (55.8%) patients with preserved GFR without anaemia; one-year mortality rates were 56.5%, 41.8%, 31.8% and 10.3% respectively in these 4 groups. Among patients with impaired GFR, anaemia was associated with an adjusted OR of 1.47 (95% CI=1.17-1.85) for one-year mortality, while among patients with preserved GFR, anaemia was associated with a higher adjusted OR of 2.07 (95% CI=1.54-2.76) for one-year mortality, interaction P<0.001.
  
  
  CONCLUSIONS
  The combination of impaired GFR and anaemia confers greater than five-fold increased risk of mortality after AMI. The differential effect of anaemia among patients with impaired and preserved GFR on mortality suggests that in patients with preserved GFR anaemia confers a greater relative hazard than in patients with impaired renal function.
authors.affiliation: National University Heart Centre, Singapore.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pinto de Carvalho
authors.forename: Peter A
authors.initials: PA
authors.lastname: McCullough
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Ling Ling
authors.initials: LL
authors.lastname: Sim
authors.forename: Huay Cheem
authors.initials: HC
authors.lastname: Tan
authors.forename: David
authors.initials: D
authors.lastname: Foo
authors.forename: Yau Wei
authors.initials: YW
authors.lastname: Ooi
authors.forename: A Mark
authors.initials: AM
authors.lastname: Richards
authors.forename: Mark Y
authors.initials: MY
authors.lastname: Chan
authors.forename: Tiong-Cheng
authors.initials: TC
authors.lastname: Yeo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology*; D015331:Cohort Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology*; D051437:Renal Insufficiency / Q000175:diagnosis / Q000401:mortality* / Q000503:physiopathology*; D012189:Retrospective Studies
keywords: Acute myocardial infarction; Anaemia; Chronic kidney disease