title: Persistent Renal Dysfunction After Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction.
abstract: We determined the incidence, predictors, and outcomes of persistent renal dysfunction (PRD) following percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Among 16 264 patients enrolled in a nationwide registry, we studied patients with AMI who had their estimated glomerular filtration rate at baseline and 1 month later (n = 3606). We used multivariate regression and propensity score (PS)-matched Cox proportional hazards to evaluate the association between PRD and outcomes. Persistent renal dysfunction occurred in 1333 (37%) patients. Significant PRD contributors included old age, low body mass index (BMI), hypertension, Killip class, and the extent of vessel disease. Persistent renal dysfunction was associated with an increased 1-year major adverse cardiac events (all-cause death, myocardial infarction, or revascularization) relative to no-PRD (entire cohort: 6.2% vs 4.5%, hazard ratio[HR] 1.63, 95% confidence interval [CI] 1.18-2.25, P = .003; PS-matched cohort: 7.2% vs 4.9%, HR 1.67, 95% CI 1.08-2.58, P = .022). In conclusion, PRD occurred in approximately one-third of patients with AMI following PCI. It was associated with old age, hypertension, low BMI, initial hemodynamic instability, and extent of vessel disease and was a predictor of worse outcomes at 1 year.
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Jeong Cheon
authors.initials: JC
authors.lastname: Choe
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Kwang Soo
authors.initials: KS
authors.lastname: Cha
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Jinhee
authors.initials: J
authors.lastname: Ahn
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Jin Sup
authors.initials: JS
authors.lastname: Park
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Hye Won
authors.initials: HW
authors.lastname: Lee
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Jun-Hyok
authors.initials: JH
authors.lastname: Oh
authors.affiliation: 2 Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Jeong Su
authors.initials: JS
authors.lastname: Kim
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Jung Hyun
authors.initials: JH
authors.lastname: Choi
authors.affiliation: 2 Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Yong Hyun
authors.initials: YH
authors.lastname: Park
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Han Cheol
authors.initials: HC
authors.lastname: Lee
authors.affiliation: 2 Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: June Hong
authors.initials: JH
authors.lastname: Kim
authors.affiliation: 2 Pusan National University Yangsan Hospital, Yangsan, South Korea.
authors.forename: Kook Jin
authors.initials: KJ
authors.lastname: Chun
authors.affiliation: 1 Pusan National University Hospital, Busan, South Korea.
authors.forename: Taek Jong
authors.initials: TJ
authors.lastname: Hong
authors.affiliation: 3 Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: 3 Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000792:Angiography; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D015994:Incidence; D007674:Kidney Diseases / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D016896:Treatment Outcome
keywords: acute myocardial infarction; percutaneous coronary intervention; persistent renal dysfunction; prognosis