Document Detail


Prognostic effect of renal dysfunction after ST-segment elevation myocardial infarction with and without heart failure.
MedLine Citation:
PMID:  16290104     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: The present study was designed to assess, 1) the independent prognostic effect of renal dysfunction on all-cause mortality in the setting of acute myocardial infarction with ST-segment elevation (STEMI), and 2) to determine if such effect varies based upon the presence of heart failure (HF) on admission. METHODS: 549 consecutive patients admitted with the diagnosis of STEMI were prospectively recruited in a teaching hospital in Spain. Serum creatinine (sCr) and glomerular filtration rate (GFR) were obtained on admission, together with other relevant information used for risk stratification. The independent effect of sCr and GFR on long-term mortality was determined by Cox regression analysis. Main outcome was all-cause mortality, with a median follow-up of 1 year. RESULTS: In a multivariate analysis the degree of renal impairment was a strong predictor of mortality in patients without clinical evidence of HF at admission (HR=1.15; 95% CI 1.10 to 1.19 and HR=1.58; 95% CI 1.30 to 1.81) for sCr (per 0.1 mg/dl) and GFR (per decreasing 10 ml/min/1.73 m2), respectively. In the group with HF, the effect was less pronounced (HR=1.03; 95% CI 1.01 to 1.04 and HR=1.17; 95% CI 1.02 to 1.37) for sCr and GFR, respectively. CONCLUSIONS: In the setting of STEMI, renal dysfunction estimates showed a differential prognostic effect depending on HF status, with a greater impact seen in patients without clinical evidence of HF.
Authors:
Vicente Bertomeu-Gonzalez; Julio Núñez; Eduardo Núñez; Lorenzo Fácila; Juan Sanchis; Vicent Bodí; Mauricio Pellicer; María J Bosch; Angel Martínez; Francisco J Chorro; Angel Llàcer
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Publication Detail:
Type:  Journal Article     Date:  2005-11-10
Journal Detail:
Title:  International journal of cardiology     Volume:  112     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-09-18     Completed Date:  2006-10-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  159-65     Citation Subset:  IM    
Affiliation:
Cardiology Department, Valencia Clinic University Hospital, Avda. Blasco Ibáñez 17, 46010 Valencia, Spain. vbertog@secardiologia.es
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MeSH Terms
Descriptor/Qualifier:
Aged
Comorbidity
Creatinine / blood
Female
Glomerular Filtration Rate
Heart Failure / epidemiology*,  physiopathology
Humans
Kidney / physiopathology*
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / epidemiology,  mortality*,  physiopathology*
Prognosis
Prospective Studies
Risk Assessment
Stroke Volume
Survival Analysis
Chemical
Reg. No./Substance:
60-27-5/Creatinine

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


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