Chronic Kidney Disease, But Not Diabetes, Can Predict 30-Day Outcomes in Patients with ST-Elevation Myocardial Infarction after Primary Percutaneous Coronary Intervention: A Single-Center Experience.
BACKGROUND
Patients with acute coronary syndrome and impaired renal function have been shown to have high mortality. However, there is scarce literature to date addressing the impact of diabetes mellitus (DM) and renal function on clinical outcomes of ST elevation myocardial infarction (STEMI) in Taiwan.


METHODS
This study enrolled 512 STEMI patients who received primary percutaneous coronary intervention. Patients were divided into 4 groups including group 1: patients without DM or CKD (nDM-nCKD); group 2: patients with DM but without CKD (DM-nCKD); group 3: patients with CKD but without DM (nDM-CKD); group 4: patients with DM and CKD (DM-CKD). Patients were also classified into four groups based on their estimated glomerular filtration rates (eGFR): stage 1 (eGFR ≥ 90 ml/min/1.73 m(2), n = 163), stage 2 (eGFR = 89-60 ml/min/1.73 m(2), n = 171), stage 3 (eGFR = 59-30 ml/min/1.73 m(2), n = 136), and stage 4 (eGFR < 30 ml/min/1.73 m(2), n = 42). The complication rates, length of hospital stay, and 30-day outcomes were analyzed.


RESULTS
The patients in both the nDM-CKD group and DM-CKD group had higher incidences of hypotension, intra-aortic balloon counterpulsation use, and respiratory failure (p < 0.005). They had significantly longer hospital stay and 30-day mortality rates (p < 0.001). The patients with CKD stage 3 and 4 had longer hospital stay and higher 30-day mortality rates (p < 0.001). However, DM was not an independent factor on the length of hospital stay and 30-day mortality rates.


CONCLUSIONS
STEMI patients with impaired renal function, but not DM, had significantly longer hospital stay and higher 30-day mortality rates.


BACKGROUND
Chronic kidney disease; Diabetes mellitus; Mortality; Primary percutaneous coronary intervention; ST-segment elevation myocardial infarction.
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Cheng-Chung
CC
Hung
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan; ; Department of Physical Therapy, Fooyin University;
Wei-Chun
WC
Huang
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan;
Kuan-Rau
KR
Chiou
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan;
Chin-Chang
CC
Cheng
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Feng-Yu
FY
Kuo
Department of Physical Therapy, Fooyin University;
Jin-Shiou
JS
Yang
Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Ko-Long
KL
Lin
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Cheng-Hung
CH
Chiang
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan;
Shin-Hung
SH
Hsiao
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan;
Chi-Cheng
CC
Lai
Cheng Shiu University, Kaohsiung, Taiwan.
Tzu-Wen
TW
Lin
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan;
Guang-Yuan
GY
Mar
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan;
Chuen-Wang
CW
Chiou
Cardiovascular Medical Center, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; ; School of Medicine, National Yang-Ming University, Taipei, Taiwan;
Chun-Peng
CP
Liu