Relationship between glomerular filtration rate and in-hospital mortality of patients with non-st-segment elevation myocardial infarction - korean acute myocardial infarction registry-based analysis

Abstract

Purpose: Renal function is well known cardiovascular risk state. Prognostic significance of renal dysfunction in Korean patients with Non ST-segment elevation myocardial infarction (NSTEMI) was not yet fully analyzed. The objective of the present study was to further evaluate the prognostic impact of renal dysfunction on in-hospital mortality in NSTEMI patients using data from Korean Acute Myocardial Infarction Registry (KAMIR). Methods: From January 2008 to July 2011, total 6,590 patients data on clinical, angiographic and in-hospital mortality were analyzed in this study. Patients were stratified as four groups by estimated GFR (eGFR): ≥90 mL/min/1.73m2 or normal renal function (Group 1, n=2243); 60-89 mL/min/1.73m2 or minimally impaired renal function (Group 2, n=2652); 30–59 mL/min/1.73m2 or moderate renal dysfunction {Group 3, n=1227}; and <30 ml/min or severe renal dysfunction including established renal failure {Group 4, n=468). Results: In-hospital mortality rates increased significantly as eGFR decreased. Interesingly, mortality rate shows about two-fold increase according to group. (Group 1, 2, 3, 4: 1.4%, 3.3%, 7.4%, 11.8%, p<0.001) On multivariate logistic regression analysis, adjusted odds ratio for in-hospital mortality rate was 2.81 in the group 3 patients, and 5.10 in the group 4 patients compared to the group 1 patients. ![Figure][1] Conclusion: The principal finding of our study is that decreased eGFR was an independent predictor of in-hospital mortality in patients with NSTEMI. [1]: pending:yes