期刊
INTERNATIONAL JOURNAL OF MEDICAL SCIENCES
卷 18, 期 13, 页码 2842-2848出版社
IVYSPRING INT PUBL
DOI: 10.7150/ijms.61891
关键词
myocardial infarction; cardiac remodeling; renal function; mortality; heart failure
资金
- Chi-Mei Medical Center
- Ministry of Science and Technology [MOST 109-2326-B-384 -001 -MY3]
This study examined the impact of renal impairment on treatment, echocardiographic parameters, and outcomes in AMI patients undergoing PCI. Patients with worse renal function were older, had more comorbidities, received less guideline-directed therapy, and had poorer cardiovascular outcomes.
How renal function influences post-acute myocardial infarction (AMI) cardiac remodeling and outcomes remains unclear. This study evaluated the impact of levels of renal impairment on drug therapy, echocardiographic parameters, and outcomes in patients with AMI undergoing percutaneous coronary intervention (PCI). A total of 611 patients diagnosed with AMI underwent successful PCI, and two echocardiographic examinations were performed within 1 year after AMI. Patients were categorized according to Group 1: severely impaired estimated glomerular filtration rate (eGFR)<30, Group 2: mildly impaired 30<_eGFR<60, Group 3: potentially at risk 60<_eGFR<90 and normal eGFR >= 90 ml/min/1.73 m2. During the 5-year follow-up period, the primary endpoints were cardiovascular mortality and outcomes. Patients with worse renal function (eGFR<30) were older and had a higher prevalence of hypertension and diabetes, but relatively few were smokers or had hyperlipidemia. Despite more patients with lesions of the left anterior descending artery, those with worse renal function received suboptimal guideline-directed medical therapy (GDMT). Notably, patients with worse renal function presented with worse left ventricular function at baseline and subsequent follow-up. Kaplan-Meier analysis revealed increased cardiovascular death, development of heart failure, recurrent AMI and revascularization in patients with worse renal function. Notably, as focusing on patients with ST elevation MI, the similar findings were observed. In multivariable Cox regression, impaired renal function showed the most significant hazard ratio in cardiovascular death. Collectively, in AMI patients receiving PCI, outcome differences are renal function dependent. We found that patients with worse renal function received less GDMT and presented with worse cardiovascular outcomes. These patients require more attention.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据