What is the clinical evidence from this study?

Study design: Observational. Population: ST elevation myocardial infarction (STEMI) with renal dysfunction (n=2083). Intervention: Severe renal dysfunction (eGFR 90 ml/min/1.73 m2). Primary outcome: In-hospital all-cause mortality (Adjusted OR 5.3, 95% CI 1.15-25.51, p=0.0383).

What question did this study set out to answer?

This research aims to determine how baseline eGFR predicts in-hospital outcomes for STEMI patients with renal dysfunction.

April 13, 2026Open Access

In-hospital adverse clinical outcomes of ST elevation myocardial infarction patients with renal dysfunction. Insights from the Saudi Project for Assessment of Coronary Events.

Key Result

Severe baseline renal dysfunction (eGFR < 30 ml/min) in patients presenting with STEMI independently predicted a significantly higher risk of in-hospital death (adjusted OR 5.3) compared to normal renal function.

Key Points

This research aims to determine how baseline eGFR predicts in-hospital outcomes for STEMI patients with renal dysfunction.
Analyzed data from the SPACE registry of STEMI patients in Saudi Arabia.
Classified patients based on eGFR levels into renal function categories.
Evaluated treatment received and outcomes related to varying eGFR levels.
Out of 2058 patients, 1058 had renal dysfunction.
Patients with renal dysfunction were older and had more atherosclerosis risk factors.
Lower eGFR correlated with reduced likelihood of receiving key therapies.
Patients with eGFR <30 ml/min had an adjusted odds ratio of 5.3 for in-hospital death.

Study Design

Type

Observational (n=2,083)

Multicenter

Yes

Structured PICO

Does baseline eGFR predict in-hospital adverse clinical outcomes and impact hospital therapies in STEMI patients?

Population

2,058 Saudi patients presenting with ST elevation myocardial infarction (STEMI) and a baseline serum creatinine enrolled in the SPACE registry

Intervention

Baseline eGFR levels (categorized into >90.1, 90-60.1, 60-30, and <30 ml/min/1.73 m2)

Comparator

Normal renal function (eGFR >90.1 ml/min)

Outcome

In-hospital death and major adverse cardiovascular outcomeshard clinical

Low baseline eGFR in STEMI patients is an independent predictor of major adverse cardiovascular outcomes and is associated with less aggressive in-hospital therapy.

Main Result

Effect estimate: Adjusted OR 5.3 (95% CI 1.15-25.51)

p-value: p=0.0383

Limitations

Observational, non-randomized study design with inherent biases
Glomerular filtration rate (GFR) was calculated but not directly measured
Data on the use of renal replacement therapy and long-term outcomes were not prospectively collected
Potential unmeasured comorbidities not collected in the case report form

Abstract

OBJECTIVES: To explore the prognostic value of baseline estimated glomerular filtration rate (eGFR) in Saudi patients presenting with ST elevation myocardial infarction (STEMI), and its impact on hospital therapies. METHODS: The STEMI patients with a baseline serum Creatinine enrolled in the SPACE (Saudi Project for Assessment of Coronary Events) registry were analyzed. This study was performed in several regions in Saudi Arabia between December 2005 to December 2007. Based on eGFR levels, patients were classified into: more than 90.1 ml/min (normal renal function), 90-60.1 (borderline/mildly impaired renal function), 60-30 (moderate renal dysfunction), and less than 30 ml/min/1.73 m2 (severe renal dysfunction). RESULTS: Two thousand and fifty-eight patients qualified for this study. Of these, 1058 patients had renal dysfunction. Patients with renal dysfunction were older, and had a higher prevalence of risk factors for atherosclerosis. Patients with moderate or severe renal dysfunction were less likely to be treated with beta blockers, angiotensin converting enzymes inhibitors, statins, or reperfusion therapies. Significantly worse outcomes were seen with lower eGFR in a stepwise fashion. The adjusted odds ratio of in-hospital death in patients with eGFR less than 30 ml/min was 5.3 (95% CI, 1.15-25.51, p=0.0383). CONCLUSIONS: A low baseline eGFR in STEMI patients is an independent predictor of all major adverse cardiovascular outcomes, and a marker for less aggressive in-hospital therapy.

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Cite This Study

AlSuwaida et al. (Mon,) conducted a observational in ST elevation myocardial infarction (STEMI) with renal dysfunction (n=2,083). Severe renal dysfunction (eGFR < 30 ml/min/1.73 m2) vs. Normal renal function (eGFR > 90 ml/min/1.73 m2) was evaluated on In-hospital all-cause mortality (Adjusted OR 5.3, 95% CI 1.15-25.51, p=0.0383). Severe baseline renal dysfunction (eGFR < 30 ml/min) in patients presenting with STEMI independently predicted a significantly higher risk of in-hospital death (adjusted OR 5.3) compared to normal renal function.

synapsesocial.com/papers/69dc87983afacbeac03e9e0c https://doi.org/https://doi.org/10.15537/1658-3175.5355

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