Document Detail


Different types of renal dysfunction in patients with acute myocardial infarction treated with percutaneous coronary intervention.
MedLine Citation:
PMID:  17391223     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The prognostic significance of different types of renal dysfunction in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) has not been well characterized. METHODS: The single-center AMI registry encompassed 1,486 consecutive AMI patients treated with PCI, who were followed by mean 29.7 months. Subjects with an estimated glomerular filtration rate <60 mL/min per 1.73 m2 at baseline were selected (n = 283, 19.0%) and incorporated into the chronic kidney disease (CKD) group. The control group consisted of 1,203 subjects with normal renal function (81.0%). The CKD patients were divided into subgroups: with contrast-induced nephropathy - CKD + CIN (n = 68, 4.6%) and without - CKD-CIN (n = 215, 14.5%). RESULTS: Remote mortality rate was significantly higher in CKD group (34.6%) and in particular subgroups: CKD + CIN (47.0%), CKD-CIN (31.0%) than in controls (9.1%, P < 0.001 for all study groups vs controls). Multivariate analysis identified CKD as an independent predictor of any-cause death in the whole population (hazard ratio [HR] 1.77, 95% confidence interval [CI] 1.60-1.94, P < 0.001). Similarly, CKD + CIN contrary to CKD-CIN had significant and independent influence on remote survival in study population (HR 2.16, 95% CI 1.95-2.37, P < 0.001). CONCLUSIONS: CKD and its types have significant, negative influence on long-term survival in AMI patients treated with PCI. It is especially strongly expressed in those CKD patients who develop contrast-induced nephropathy, which occurrence is an independent risk factor of mortality associated with over twofold increase of death hazard.
Authors:
Jacek Kowalczyk; Radoslaw Lenarczyk; Oskar Kowalski; Beata Sredniawa; Agata Musialik-Lydka; Mariusz Gasior; Lech Polonski; Marian Zembala; Janusz Gumprecht; Zbigniew Kalarus
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  20     ISSN:  0896-4327     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-29     Completed Date:  2007-06-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  143-52     Citation Subset:  IM    
Affiliation:
1st Department of Cardiology, Medical University of Silesia, Silesian Center for Heart Diseases, Zabrze, Poland. jacekmed@poczta.onet.pl
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Aged
Angioplasty, Transluminal, Percutaneous Coronary*
Case-Control Studies
Female
Glomerular Filtration Rate
Humans
Kidney Failure, Chronic / complications*,  diagnosis
Male
Middle Aged
Myocardial Infarction / complications*,  mortality,  therapy*
Prognosis
Prospective Studies
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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