Abstract
BackgroundRenal dysfunction is associated with worse outcomes after primary percutaneous coronary intervention (PCI). However, whether glomerular filtration rate (GFR) estimated with various equations can equally predict outcomes after ST-Elevation Myocardial Infarction (STEMI) is still debated.MethodsWe compared the clinical impact of 3 different creatinine-based equations (Cockcroft and Gault (CG), CKD-epidemiology (CKD-EPI) and Full Age Spectrum (FAS)) to predict 1-year mortality in STEMI patients.ResultsAmong 1755 consecutive STEMI patients who had undergone primary PCI included between 2006 and 2011, median estimated GFR was 79 (61;96) with the CG, 81 (65;95) with CKD-EPI and 75 (60;91) mL/min/1.73 m2 with FAS equation. Reduced GFR values were independently associated with 1-year mortality risk with the 3 equations. Receiver operating curves (ROC) of CG and FAS equations were significantly superior to the CKD-EPI equation, p = 0.03 and p = 0.01, respectively. Better prediction with FAS and CG equations was confirmed by net reclassification index.ConclusionsOur results suggest that in STEMI patients who have undergone primary PCI, 1-year mortality is better predicted by CG or FAS equations compared to CKD-EPI.
Highlights
Chronic Kidney Disease (CKD) is associated with higher early and late mortality risk in many cardiovascular diseases [1,2,3,4]
Reduced glomerular filtration rate (GFR) values were independently associated with 1-year mortality risk with the 3 equations
Our results suggest that in ST-Elevation Myocardial Infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI), 1-year mortality is better predicted by CG or FAS equations compared to CKD-EPI
Summary
Chronic Kidney Disease (CKD) is associated with higher early and late mortality risk in many cardiovascular diseases [1,2,3,4] This over-risk has been studied in patients with ST-Elevation Myocardial Infarction (STEMI) both on the short- and long term [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21]. The main objective of this study was to compare the performance of 3 different creatinine-based equations: the CG [27], the CKD-epidemiology (CKD-EPI)[29] and the Full Age Spectrum (FAS) [30]) to predict 1-year mortality in STEMI patients after primary PCI. Whether glomerular filtration rate (GFR) estimated with various equations can predict outcomes after ST-Elevation Myocardial Infarction (STEMI) is still debated
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