Abstract 1527: Impact Of Glomerular Filtration Rate On Outcome In Consecutive Patients With Stemi In Clinical Practice: Results Of The Acos-registry

Abstract

Background: Patients with renal failure have a higher cardiovascular morbidity and mortality. Little is known about the impact of renal failure on the acute outcome of ST-elevation myocardial infarction (STEMI) in clinical practice. Methods: Between 2000 and 2002 a total of 8303 consecutive patients with STEMI were enrolled into the multicenter ACOS-registry in Germany. We examined the impact of the glomerular filtration rate (GFR) on hospital outcome in clinical practice. GFR was calculated using the Cockroft-Gault-Formula. Results: Patients with reduced GFR were older, more often female, more often had prior myocardial infarctions and coronary interventions, a higher prevalence of concomitant diseases and a worse TIMI-risk score. than patients with GFR >90 ml/min. Patients with impaired GFR did receive acute reperfusion therapy significantly less often. After adjustment for these differences by multivariate regression analysis, renal failure was associated with significant higher hospital mortality (GFR 30–59 ml/min: OR 2.38; GFR < 30 ml/min: OR 5.18, p<0.01). Conclusion: In consecutive STEMI-patients severe renal failure (GFR<30 ml/min) was independently associated with a more than 5-fold increased hospital mortality in clinical practice.