title: Renal insufficiency was correlated with 2-year mortality for rural female patients with ST-segment elevation acute myocardial infarction after reperfusion therapy: a multicenter, prospective study.
abstract: BACKGROUND
  Renal insufficiency (RI) following ST-segment elevation acute myocardial infarction (STEMI) is associated with a worse clinical prognosis. We investigated the impact of RI on long-term mortality in rural female patients with STEMI and evaluated prognostic factors.
  
  
  METHODS
  A prospective cohort study of 436 consecutive rural female patients who were successfully treated with reperfusion therapy for STEMI between May 2009 and August 2011 in secondary care hospitals in Liaoning province northeastern China and followed up for 2 years. Patients were divided into three groups by estimated glomerular filtration rate (eGFR): Normal group, eGFR ≥90 mL/min/1.73 m(2) (n = 233). Moderate group, eGFR 60-90 mL/min/1.73 m(2) (n = 108). RI group, eGFR <60 mL/min/1.73 m(2) (n = 95). The primary outcome was 2-year mortality.
  
  
  RESULTS
  During follow-up (mean 741 ± 118 days), the RI group had a significantly higher mortality than the other groups (24.21 % vs. 6.87 % and 10.19 %, p < 0.001). The RI group had significantly higher hospital mortality (7.37 % p = 0.045 vs. Normal group). RI increased the risk of hospital mortality (hazard ratio (HR) 1.832, 95 % CI 1.017-3.091, p = 0.033), and increased the risk of 2-year mortality (HR 3.872, 95 % CI 2.004-6.131, p < 0.001). Multivariate analysis showed eGFR <90 ml/min/1.73 m(2) and age ≥75 years as independent predictors of mortality at 2 years. In detail these were eGFR 60-90 ml/min/1.73 m(2) with HR 2.081, 95%CI 1.250-2.842, p < 0.001; eGFR <60 ml/min/1.73 m(2) with HR 3.872, 95%CI 2.004-6.131, p < 0.001; age ≥75 with HR 1.461, 95%CI 1.011-1.952, p = 0.024.
  
  
  CONCLUSIONS
  RI had a powerful correlation with long-term mortality for rural female patients with STEMI after reperfusion therapy.
authors.affiliation: Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China. plateau1216@163.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Cardiology, Dandong Center Hospital, Dandong, Liaoning, 118000, China. doctor-jdm@163.com.
authors.forename: Daming
authors.initials: D
authors.lastname: Jiang
authors.affiliation: Department of Cardiology, First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning, 116011, China. zhonghb100@aliyun.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Geriatric Cardiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China. sunyujiaomy08@sina.cn.
authors.forename: Yujiao
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China. renlina1980@163.com.
authors.forename: Lina
authors.initials: L
authors.lastname: Ren
authors.affiliation: Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China. dandanmengxingle@163.com.
authors.forename: Dandan
authors.initials: D
authors.lastname: Fan
authors.affiliation: Department of Cardiology, First Affiliated Hospital of China Medical University, Shenyang, Liaoning, 110001, China. qiguoxiansci@126.com.
authors.forename: Guoxian
authors.initials: G
authors.lastname: Qi
mesh_terms: D005260:Female; D005919:Glomerular Filtration Rate; D017052:Hospital Mortality; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D012008:Recurrence; D051437:Renal Insufficiency / Q000150:complications*; D012307:Risk Factors; D012424:Rural Population; D015912:Thrombolytic Therapy