Key result
Transient renal decline during post-MI hospitalization linked to ~2-fold higher 5-year mortality.
Why the study?
The mortality risk associated with renal function decline during hospitalization for myocardial infarction was not well characterized.
Does renal function decline during hospitalization for myocardial infarction increase the risk of 5-year all-cause mortality?
Cohort (n=5,659)
Does renal function decline during hospitalization for myocardial infarction increase the risk of 5-year all-cause mortality?
Hazard Ratio: 2.08 (95% CI 1.7–2.55)
p-value: p=< 0.0001
Even a transient decline in renal function to moderate insufficiency during hospitalization for myocardial infarction is associated with a significantly increased risk of 5-year all-cause mortality, similar to permanent moderate insufficiency.
May flag higher long-term mortality risk after MI; leaves open whether renoprotection during hospitalization improves survival.
Aim: We analyzed the mortality risk of myocardial infarction (MI) patients according to renal function, observed during hospitalization. Materials & methods: Patients hospitalized for MI between 2006 and 2018 were followed (n = 5659). We divided the sample into four groups by estimated glomerular filtration (eGFR) [ml/min]: normal functions (lowest eGFR during hospitalization >60); transiently moderate insufficiency (lowest eGFR >30 and ≤60, highest >60); permanently moderate insufficiency (highest eGFR >30 and ≤60); severe insufficiency (highest and lowest eGFR ≤30). Results: Permanently moderate renal insufficiency indicates increased 5-years all-cause mortality (hazard risk ratio: 2.27 [95% CIs: 1.87–2.75], p < 0.0001), but a similar risk was found in patients with the only transient decline of renal functions (hazard risk ratio: 2.08 [95% CIs: 1.70–2.55], p < 0.0001). Both moderate insufficiency subgroups (transient/permanent) did not statistically differ regarding mortality risk. Conclusion: Even just fluctuation of eGFR toward moderate insufficiency during hospitalization represents an important prognostic indicator in MI patients.
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Mayer et al. (2021) conducted a cohort in Myocardial infarction (n=5,659). Transiently moderate renal insufficiency vs. Normal renal function (lowest eGFR >60 ml/min) was evaluated on 5-year all-cause mortality (HR 2.08, 95% CI 1.70-2.55, p=< 0.0001). Transient decline of renal function to moderate insufficiency during hospitalization for myocardial infarction increased 5-year all-cause mortality (HR 2.08; 95% CI 1.70-2.55; p<0.0001).
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