Key result
In patients with ST-elevation myocardial infarction, a glomerular filtration rate < 60 ml/min/1.73 m2 was associated with significantly higher rates of acute pulmonary oedema and cardiogenic shock compared to a rate ≥ 90 ml/min/1.73 m2 (10.3% vs 0.9%, p < 0.05).
Why the study?
The study was conducted to examine in-hospital complications in patients with acute ST-elevation myocardial infarction and different renal function.
Does lower renal function increase the risk of in-hospital complications in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention?
Observational (n=351)
No
Does lower renal function increase the risk of in-hospital complications in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention?
Absolute Event Rate: 10.3% vs 0.9%
p-value: p=< 0.05
Lower glomerular filtration rate is associated with a significantly higher risk of in-hospital complications, including pulmonary edema, cardiogenic shock, and arrhythmias, in patients with STEMI undergoing PCI.
Reduced GFR may flag higher in-hospital risk during STEMI PCI; leaves open causality and need for prospective validation.
Objective The goal of this study was to examine in-hospital complications in patients with acute ST-elevation myocardial infarction with a different renal function. Methods 351 patients were included in the study. Percutaneous coronary intervention was performed on all patients. 116 had a glomerular filtration rate < 60 ml/min/1.73 m 2 (Group 1), 120 ≥ 60 ml/min/1.73 m 2 and < 90 ml/min/1.73 m 2 (Group 2) and 115 ≥ 90 ml/min/1.73 m 2 (Group 3). Other parameters in the groups were comparable. The composite rate of acute pulmonary oedema and cardiogenic shock, in-hospital pneumonia, pulseless ventricular tachycardia or ventricular fibrillation, new-onset atrial fibrillation or atrial flutter, and in-hospital death were all compared among study groups. Results Mean glomerular filtration rate in Group 1 was 48.2±10.4; in Group 2, 74.7±8.7; and in Group 3, 104.1±14.6 (p < 0.001). The incidence of atrial fibrillation or atrial flutter was higher in Group 1 than in Groups 2 and 3: 12.1%, 5.8%, and 3.5%, respectively (p < 0.05). Group 3 had significantly lower rates of acute pulmonary oedema and cardiogenic shock than Groups 1 and 2: 10.3%, 5.8%, and 0.9%, respectively (p < 0.05). There was also a significant difference between groups when comparing the rate of in-hospital pneumonia: Group 1 had reasonably higher rates of in-hospital pneumonia than Group 2 and Group 3: 13.8%, 6.7%, and 4.3% (p < 0.05), respectively. The authors discovered no significant differences in additional complications: pulseless ventricular tachycardia or ventricular fibrillation occurred in 2.6%, 3.3%, and 0.9%, respectively (p > 0.05). in-hospital death was 3.4% in Group 1; 0.8% in Group 2: and 0 in Group 3, (p > 0.05). Conclusion Patients with lower glomerular filtration rate were more likely to develop in-hospital acute pulmonary oedema and cardiogenic shock, pneumonia, and new-onset atrial fibrillation or atrial flutter in ST-elevation myocardial infarction.
No takes yet. Share an insight, caveat, or question.
Petrosyan et al. (2022) conducted an observational in ST-elevation myocardial infarction (STEMI) (n=351). Impaired renal function (GFR < 60 ml/min/1.73 m2) vs. Normal renal function (GFR ≥ 90 ml/min/1.73 m2) was evaluated on Acute pulmonary oedema and cardiogenic shock (p=< 0.05). In patients with ST-elevation myocardial infarction, a glomerular filtration rate < 60 ml/min/1.73 m2 was associated with significantly higher rates of acute pulmonary oedema and cardiogenic shock compared to a rate ≥ 90 ml/min/1.73 m2 (10.3% vs 0.9%, p < 0.05).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: