title: Renal Dysfunction was an Independent Predictor of In-Hospital Death and Ventricular Rupture in Patients With Acute Myocardial Infarction.
abstract: BACKGROUND
  Apart from the severity of myocardial infarction and coronary artery disease, several predictors of in-hospital death (In-HD) are suggested in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  We investigated predictors of In-HD and ventricular rupture (VR) including ventricular septal rupture (VSR) and free wall rupture (FWR) with stepwise multivariable logistic regressions in 1,042 patients admitted to our Cardiovascular Center within 48 hours from symptom onset for the first attack of AMI.
  
  
  RESULTS
  In-HD, VSR, and FWR were observed in 78 cases (7.5%), 14 cases of which 13 cases were In-HD, and 13 cases of which 6 cases were In-HD, respectively. Apart from the disease severity, age and renal dysfunction (RD) defined by estimated glomerular filtration rate of lower than 60 mL/min/ 1.73 m2were independent positive predictors of In-HD (the odds ratios (ORs) (95% confidence interval (CI)): 1.04 (1.01 - 1.06) P = 0.0069 and 5.75 (3.12 - 10.59) P < 0.0001, respectively) and hypercholesterolemia was an independent negative predictor for In-HD (OR (95% CI): 0.34 (0.17 - 0.67) P = 0.0017). After including the categories of coronary disease, ventricular rupture, and ejection fraction in predictors, RD remained an independent predictor of In-HD (OR (95% CI): 6.65 (2.67 - 16.60) P < 0.0001). Age (OR (95% CI): 1.07 (1.02 - 1.12) P = 0.0064), RD (OR (95% CI): 2.77 (1.18 - 6.49) P = 0.019), and diabetes (OR (95% CI): 2.52 (1.12 - 5.71) P = 0.026) were independent predictors of VR.
  
  
  CONCLUSIONS
  RD was an independent predictor of In-HD and VR in patients with initial AMI.
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Goto
authors.affiliation: Medical Check-up Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Oda
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Hirooki
authors.initials: H
authors.lastname: Matsushita
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Takarada
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Tomita
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Saito
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Fuse
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Fujita
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Kitazawa
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Takahashi
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Masahito
authors.initials: M
authors.lastname: Sato
authors.affiliation: Cardiovascular Center, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Okabe
authors.affiliation: Department of Research and Development, Tachikawa Medical Center, Nagaoka, Japan.
authors.forename: Yoshifusa
authors.initials: Y
authors.lastname: Aizawa
keywords: Acute myocardial infarction; In-hospital death; Renal dysfunction; Ventricular rupture