title: Prognostic impact of chronic kidney disease and anemia at admission on in-hospital outcomes after primary percutaneous coronary intervention for acute myocardial infarction.
abstract: Cardiorenal anemia syndrome has recently been receiving greater attention; however, data regarding the relationship between chronic kidney disease (CKD)/anemia on presentation and in-hospital outcome in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI) are still limited in Japan.A total of 1,447 primary PCI-treated AMI patients were classified into 4 groups according to the presence of CKD and/or anemia on hospital admission (with CKD/with anemia n = 222, with CKD/without anemia n = 299, without CKD/with anemia n = 151, without CKD/without anemia n = 775). Angiographic acute results of primary PCI were similar among the 4 groups. The patients with CKD had a significantly higher in-hospital overall mortality rate than the patients without CKD, and in the presence or absence of CKD, patients with anemia tended to have a higher in-hospital mortality rate than the patients without anemia. According to a multivariate analysis, anemia on admission was found to be an independent predictor of in-hospital mortality, whereas admission CKD and admission eGFR were statistically not independent predictors. Moreover, the multivariable adjusted odds ratio of in-hospital death in AMI patients with CKD alone was 1.855 (95% CI 0.929-3.706), and that in AMI patients with CKD/with anemia was 3.384 (95% CI 1.697-6.748).These results suggest that among real-world, unselected Japanese AMI patients undergoing primary PCI, the combination of CKD and anemia on admission confers significant adverse effects on in-hospital mortality.
authors.affiliation: Department of Cardiology, Kyoto First Red Cross Hospital.
authors.forename: Jun
authors.initials: J
authors.lastname: Shiraishi
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kohno
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Takashi
authors.initials: T
authors.lastname: Yanagiuchi
authors.forename: Sho
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ito
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kimura
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsui
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masayasu
authors.initials: M
authors.lastname: Arihara
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hyogo
authors.forename: Takatomo
authors.initials: T
authors.lastname: Shima
authors.forename: Takahisa
authors.initials: T
authors.lastname: Sawada
authors.forename: Satoaki
authors.initials: S
authors.lastname: Matoba
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamada
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Matsumuro
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shirayama
authors.forename: Makoto
authors.initials: M
authors.lastname: Kitamura
authors.forename: Keizo
authors.initials: K
authors.lastname: Furukawa
mesh_terms: D000368:Aged; D000740:Anemia / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000601:surgery*; D010343:Patient Admission; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications; D011379:Prognosis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors