In-hospital complications in acute ST-elevation myocardial infarction depending on renal function.

Abstract

To analyze in-hospital complications in patients with acute ST-elevation myocardial infarction (STEMI) depending on renal function. Observational study in patients with STEMI. The study included 169patients undergoing primary percutaneous coronary intervention. In all patients glomerular filtration rate (GRF) was calculated using the Modification of Diet in Renal Disease Study (MDRD) equation. Of these patients, 84had aGFR ≥ 90 ml/min/1.73 m2 (Group1) and 85 < 90 ml/min/1.73 m2 (Group2). Other parameters in both groups were comparable. Study groups were followed to compare Killip class > 2acute heart failure, in-hospital pneumonia, pulseless ventricular tachycardia or ventricular fibrillation, new onset atrial fibrillation, and high grade atrioventricular block. All patients were treated according to European Society of Cardiology (ESC) guidelines for the management of acute myocardial infarction in patients presenting with ST elevation. Mean GFR in Group1 was 107.6 [Formula: see text] and in Group2 75.3 [Formula: see text] 11.2 (p < 0.0001). The incidence of atrial fibrillation was higher in Group2: in Group1 and Group2 the atrial fibrillation rate was 1.12% (one of 84) vs 8.24% (seven of 85) (p = 0.031), respectively. Group1 revealed significantly lower rates of acute heart failure (Killip class > 2): in Group1 and Group2 0% (0of 84patients) vs 5.88% (five of 85patients) (p = 0.024), respectively. The authors found no significant differences for other complications: in Group1 and Group2 ventricular tachycardia or ventricular fibrillation was 4.76% (four of 84patients) vs 5.89% (five of 85patients) (p = 0.75), high grade atrioventricular block was 2.38% (two of 84patients) vs 4.71% (four of 85patients) (p = 0.41), and the in-hospital pneumonia rate was 2.38% (two of 84patients) vs 4.71% (four of 85patients) (p = 0.41), respectively. Patients with lower GFR were more likely to suffer from in-hospital acute heart failure (Killip class > 2) and atrial fibrillation in STEMI despite primary percutaneous coronary intervention. Renal function did not affect in-hospital pneumonia, pulseless ventricular tachycardia or ventricular fibrillation rates. The evaluation of kidney function through GFR in STEMI patients may make in-hospital complications more predictable.