Abstract
Patients with renal dysfunction (RD) who present with acute myocardial infarction (AMI) are at a high risk for subsequent cardiovascular morbidity and mortality. We sought to evaluate changes in the short and long term mortality of AMI patients with RD compared to patients with normal renal function over the last decade. This study based on 4 bi-annually surveys was performed from 2002 to 2010 and included 9468 AMI patients, that were followed for 1year, of whom 2770 (29%) had reduced estimated GFR ([eGFR]<60ml/min/m(2)). Among patients with reduced eGFR: 1251 patients (45%) were included in the 2002-2005 surveys (early period) and 1519 (55%) in the 2006-2010 surveys (late period). Patients with RD were more likely to have advanced cardiovascular disease, multiple comorbidities and higher in-hospital, 30-day, and 1-year mortality rates (8.1%,12.3% and 23% vs. 0.7%, 1.7% and 4%, respectively; all p<0.001). Patients with RD enrolled during the late survey periods were more likely to undergo primary PCI and be discharged with current evidence based medical treatment. 1-year mortality rates were significantly lower among patients with RD who were enrolled during the late vs. early survey periods: 22% vs. 25% respectively; (Log-rank...Continue Reading
References
Nov 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·R N FoleyM J Sarnak
Feb 24, 2001·Basic Research in Cardiology·F C Luft
Oct 5, 2001·Journal of the American College of Cardiology·A Al-AhmadM J Sarnak
Jun 19, 2002·European Heart Journal·C R SørensenC Torp-Pedersen
Feb 7, 2003·Journal of the American College of Cardiology·Guruprasad ManjunathMark J Sarnak
Aug 19, 2003·Heart·J J SantopintoUNKNOWN GRACE Investigators
Sep 24, 2004·The New England Journal of Medicine·Nagesh S AnavekarMarc A Pfeffer
Aug 10, 2005·American Heart Journal·Alexander GoldbergDoron Aronson
Mar 1, 2006·American Heart Journal·François SchieleJean-Pierre Bassand
Sep 26, 2006·International Journal of Cardiology·Julio J Ferrer-HitaPedro Abreu-Gonzalez
May 16, 2007·Circulation·Karen P AlexanderUNKNOWN Society of Geriatric Cardiology
Dec 15, 2010·American Heart Journal·Amit P AminFrederick A Masoudi
Jun 29, 2011·BMC Cardiovascular Disorders·Thomas KümlerChristian Torp-Pedersen
Sep 2, 2011·Heart·Niall G CampbellCharles J Knight
Jul 6, 2012·The American Journal of Cardiology·Andrew H ColesRobert J Goldberg
Jul 26, 2012·International Urology and Nephrology·Fabio FabbianRoberto Manfredini
Mar 15, 2013·Kidney International·Sjoerd T NautaJaap W Deckers