title: Estimated glomerular filtration rate as a useful predictor of mortality in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: BACKGROUND
  This study evaluated the impact of estimated glomerular filtration rate (eGFR) on 30-day and 1-year mortalities in patients with an acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  Between January 2002 and November 2009, 1432 consecutive patients who had experienced STEMI with an onset of chest pain <12 hours of undergoing primary PCI were prospectively enrolled. Patients were categorized into group 1 (eGFR <30 mL/min/1.73 m(2)), group 2 (eGFR = 30-60 mL/min/1.73 m(2)) and group 3 (eGFR >60 mL/min/1.73 m(2)).
  
  
  RESULTS
  The incidence of a high Killip class (defined as class ≥3) upon presentation, a requirement for mechanical ventilatory support for respiratory failure and intra-aortic balloon pump support for hemodynamic instability, and duration of hospitalization were substantially higher in group 1 than in groups 2 and 3, and notably higher in group 2 compared with group 3 (all P < 0.001). Conversely, the procedural success of primary PCI was remarkably lower in group 1 compared with groups 2 and 3, and it was also notably lower in group 2 than in group 3 (all P < 0.001). Additionally, both 30-day and 1-year mortalities were markedly increased in group 1 than in groups 2 and 3, and significantly higher in group 2 than in group 3 (all P < 0.001). Multivariate analysis showed that eGFR <30 mL/min/1.73 m(2) was a significantly independent predictor of 30-day and 1-year mortalities (all P < 0.001).
  
  
  CONCLUSIONS
  eGFR <30 mL/min/1.73 m(2) was strongly and independently predictive of poor short-term and long-term prognostic outcomes in patients with STEMI undergoing primary PCI.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors.forename: Tzu-Hsien
authors.initials: TH
authors.lastname: Tsai
authors.forename: Kuo-Ho
authors.initials: KH
authors.lastname: Yeh
authors.forename: Cheuk-Kwan
authors.initials: CK
authors.lastname: Sun
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Yang
authors.forename: Shyh-Ming
authors.initials: SM
authors.lastname: Chen
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Hang
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Sheng-Ying
authors.initials: SY
authors.lastname: Chung
authors.forename: Yung-Lung
authors.initials: YL
authors.lastname: Chen
authors.forename: Chiung-Jen
authors.initials: CJ
authors.lastname: Wu
authors.forename: Hsuen-Wen
authors.initials: HW
authors.lastname: Chang
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality* / Q000503:physiopathology* / Q000601:surgery; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D016896:Treatment Outcome