Abstract
BackgroundRenal insufficiency (RI) following ST-segment elevation acute myocardial infarction (STEMI) is associated with a worse clinical prognosis. We investigated the impact of RI on long-term mortality in rural female patients with STEMI and evaluated prognostic factors.MethodsA prospective cohort study of 436 consecutive rural female patients who were successfully treated with reperfusion therapy for STEMI between May 2009 and August 2011 in secondary care hospitals in Liaoning province northeastern China and followed up for 2 years. Patients were divided into three groups by estimated glomerular filtration rate (eGFR): Normal group, eGFR ≥90 mL/min/1.73 m2 (n = 233). Moderate group, eGFR 60–90 mL/min/1.73 m2 (n = 108). RI group, eGFR <60 mL/min/1.73 m2 (n = 95). The primary outcome was 2-year mortality.ResultsDuring follow-up (mean 741 ± 118 days), the RI group had a significantly higher mortality than the other groups (24.21 % vs. 6.87 % and 10.19 %, p < 0.001). The RI group had significantly higher hospital mortality (7.37 % p = 0.045 vs. Normal group). RI increased the risk of hospital mortality (hazard ratio (HR) 1.832, 95 % CI 1.017–3.091, p = 0.033), and increased the risk of 2-year mortality (HR 3.872, 95 % CI 2.004–6.131, p < 0.001). Multivariate analysis showed eGFR <90 ml/min/1.73 m2 and age ≥75 years as independent predictors of mortality at 2 years. In detail these were eGFR 60–90 ml/min/1.73 m2 with HR 2.081, 95%CI 1.250–2.842, p < 0.001; eGFR <60 ml/min/1.73 m2 with HR 3.872, 95%CI 2.004–6.131, p < 0.001; age ≥75 with HR 1.461, 95%CI 1.011–1.952, p = 0.024.ConclusionsRI had a powerful correlation with long-term mortality for rural female patients with STEMI after reperfusion therapy.
Highlights
Renal insufficiency (RI) following ST-segment elevation acute myocardial infarction (STEMI) is associated with a worse clinical prognosis
The objective of this study was to determine the association between RI and the risk of death in STEMI patients successfully treated with percutaneous coronary intervention (PCI) or thrombolytic therapy
The inclusion criteria were: (1) STEMI was diagnosed according to European Society of Cardiology (ESC) criteria [3]; (2) it was the first time STEMI was diagnosed; (3) all patients were given primary PCI treatment within 12 h or thrombolytic therapy within 6 h after symptom onset
Summary
Renal insufficiency (RI) following ST-segment elevation acute myocardial infarction (STEMI) is associated with a worse clinical prognosis. 30 % of patients with STsegment elevation acute myocardial infarction (STEMI) have combined renal insufficiency (RI) [2]. For example women accounted for 29.6 % of the total enrolled patients in the Korea acute myocardial infarction registry study [7]. This is of concern because acute myocardial infarction mortality is higher in females than males and while there have been declines in the risk of death in men; the rate in women remains fairly constant [12]. The risk of in hospital mortality after primary PCI is significantly higher for females than males [13], and female patients with STEMI show significantly greater death rates than males [14], with younger females at much higher risk than males of the same age [15]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
