The Influence of Renal Function on In-Hospital Complications in Patients with ST-Elevation Myocardial Infarction

Q: What is the clinical evidence from this study?

Study design: Observational. Population: ST-elevation myocardial infarction (STEMI) (n=351). Intervention: Impaired renal function (GFR < 60 ml/min/1.73 m2) vs. Normal renal function (GFR ≥ 90 ml/min/1.73 m2). Primary outcome: Acute pulmonary oedema and cardiogenic shock (p=< 0.05).

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).

Study Design

Type

Observational (n=351)

Multicenter

Structured PICO

Does lower renal function increase the risk of in-hospital complications in patients with ST-elevation myocardial infarction undergoing percutaneous coronary intervention?

Population

351 patients with acute ST-elevation myocardial infarction who underwent percutaneous coronary intervention, stratified by glomerular filtration rate.

Intervention

Glomerular filtration rate < 60 ml/min/1.73 m2 (Group 1, n=116) or 60-89 ml/min/1.73 m2 (Group 2, n=120)

Comparator

Glomerular filtration rate ≥ 90 ml/min/1.73 m2 (Group 3, n=115)

Outcome

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 deathcomposite

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.

Main Result

Absolute Event Rate: 10.3% vs 0.9%

p-value: p=< 0.05

Limitations

The study included only patients ≥ 40 years of age.
Only one method (MDRD) was chosen to determine the GFR.

Abstract

Abstract 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 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.

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Cite This Study

Petrosyan et al. (Thu,) conducted a 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).

synapsesocial.com/papers/6a0ea3f12eca052da647a674 https://doi.org/https://doi.org/10.2478/rjc-2022-0023

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