Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction.
Publication/Presentation Date
12-2-2003
Abstract
BACKGROUND: The prognostic importance of renal insufficiency (RI) in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been well characterized.
METHODS AND RESULTS: PCI was performed in 2082 AMI patients without shock presenting within 12 hours of symptom onset in a prospective, multicenter randomized trial. RI was defined as a calculated (Cockroft-Gault) creatinine clearance (CrCl) < or =60 mL/min. RI at baseline was present in 18% of patients. Compared with patients without RI, patients with RI were older and were more likely to be female; to have hypertension, peripheral vascular disease, or cerebrovascular disease; and to present in heart failure. Mortality was markedly increased in patients with versus without baseline RI both at 30 days (7.5% versus 0.8%, Por =70%; 20.6% versus 11.8%, P=0.024) and infarct artery reocclusion (14.7% versus 7.3%, P=0.02).
CONCLUSIONS: Baseline RI in patients with AMI undergoing primary PCI is associated with a markedly increased risk of mortality, as well as bleeding and restenosis. Novel approaches are needed to improve the otherwise poor prognosis of patients with RI and AMI.
Volume
108
Issue
22
First Page
2769
Last Page
2775
ISSN
1524-4539
Published In/Presented At
Sadeghi, H. M., Stone, G. W., Grines, C. L., Mehran, R., Dixon, S. R., Lansky, A. J., Fahy, M., Cox, D. A., Garcia, E., Tcheng, J. E., Griffin, J. J., Stuckey, T. D., Turco, M., & Carroll, J. D. (2003). Impact of renal insufficiency in patients undergoing primary angioplasty for acute myocardial infarction. Circulation, 108(22), 2769–2775. https://doi.org/10.1161/01.CIR.0000103623.63687.21
Disciplines
Medicine and Health Sciences
PubMedID
14638545
Department(s)
Department of Medicine
Document Type
Article