PMID: 10987584Sep 15, 2000

Risks associated with renal dysfunction in patients in the coronary care unit

Journal of the American College of Cardiology
P A McCulloughSteven Borzak

Abstract

The purpose of this study was to quantify the impact of baseline renal dysfunction on morbidity and mortality in patients in the coronary care unit (CCU). The presence of renal dysfunction is an established independent predictor of survival after acute myocardial infarction and revascularization procedures. We analyzed a prospective CCU registry of 12,648 admissions by 9,557 patients over eight years at a single, tertiary center. Admission serum creatinine was available in 9,544 patients. Those not on long-term dialysis were classified into quartiles of corrected creatinine clearance, with cut-points of 46.2, 63.1 and 81.5 ml/min per 72 kg. Dialysis patients (n = 527) were considered as a fifth comparison group. Baseline characteristics, including older age, African-American race, diabetes, hypertension, previous coronary disease and heart failure, were incrementally more common across increasing renal dysfunction strata. There were graded increases in the relative risk for atrial and ventricular arrhythmias, heart block, asystole, development of pulmonary congestion, acute mitral regurgitation and cardiogenic shock across the risk strata. Survival analysis demonstrated an early mortality hazard for those with renal dysfunction...Continue Reading

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Related Concepts

Cardiac Arrhythmia
Cardiovascular Diseases
Coronary Care Units
Hemodynamics
Kidney
Myocardial Infarction
Survival Analysis
Ventricular Dysfunction, Left

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