Document Detail


The impact of renal insufficiency on in-hospital outcome in patients wit ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary interventions.
MedLine Citation:
PMID:  24142751     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Chronic renal disease is a well-known risk factor for bleeding complications in acute coronary syndrome patients. The aim of this study was to determine the impact of chronic renal disease (CRF) with STEMI treated with primary PCI on periprocedural complications.
METHODS AND RESULTS: 103 patients with ST segment elevation myocardial infarction treated with primary PCI were prospectively observed for in-hospital complications and analyzed according to the kidney function status. Endpoints included clinical and periprocedural outcomes. Major and minor bleedings were reported according to TIMI, REPLACE2 and EASY classifications.
RESULTS: Patients with CRD were at greater risk of major bleeding defined by RAPLACE-2 (20.0% vs. 2.7%; p=0.007) and TIMI (13.3% vs. 1.3%, p=0.018) classifications; and had more grade 2 EASY scale hematomas (20.0% vs. 2.7%; p=0.007). Vascular access crossover during PCI occurred 8-fold more often among CRD patients (33.3% vs. 4,0%, p<0.001). Grade 3 TIMI flow was achieved less frequently in CRD patients (60% vs. 89.3%, p=0.004). CRD predisposed to contrast-induced nephropathy (35.7% vs. 5.7%; p<0.001) and ischemic stroke (14.3% vs. 0.0%; p=0.004).
CONCLUSIONS: CRD in STEMI patients undergoing primary PCI is a risk factor for major and minor bleeding complications including major bleeding, moderate hematomas, contrast induced nephropathy and ischemic stroke. Treatment and diagnostic measures should be taken in CRD patients to reduce severity of periprocedural complications.
Authors:
Lukasz Koltowski; Adam Lewandowski; Karolina Chojnacka; Krzysztof J Filipiak; Janusz Kochman; Grzegorz Opolski
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-10-21
Journal Detail:
Title:  Kardiologia polska     Volume:  -     ISSN:  0022-9032     ISO Abbreviation:  Kardiol Pol     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2013-10-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376352     Medline TA:  Kardiol Pol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1st Department of Cardiology, Medical University of Warsaw. jkochman@tlen.pl.
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