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Clinical outcomes and therapeutic strategy in patients with acute myocardial infarction according to renal function - Data from the Korean Acute Myocardial Infarction Registry

Circulation Journal, ISSN: 1346-9843, Vol: 72, Issue: 9, Page: 1410-1418
2008
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Article Description

Background: The aim of the present study was to evaluate the relationship between clinical outcomes after acute myocardial infarction (MI) and renal function by glomerular filtration rate (GFR) in patients with normal or mildly elevated serum creatinine concentrations. Methods and Results: As part of the Korean Acute Myocardial Infarction Registry (KAMIR), 6,834 acute MI patients with a serum creatinine concentration of ≤2.0 mg/dl were enrolled from November 2005 to December 2006. The renal function was stratified arbitrary to 5 groups: (1) normal function, >90.0; (2) preserved function, 75.0-89.9; (3) mild dysfunction, 60.0-74.9; (4) moderate dysfunction, 45.0-59.9; (5) severe dysfunction, <45ml·min·;1.73m. Clinical characteristics, mortality and adverse events were analyzed among each group. Although reperfusion and medical therapies were underused, the rates of mortality and adverse events were increased with declining renal function. After adjustment with confounders, severe and moderate renal dysfunctions were important risk predictors of in-hospital mortality, long-term mortality and adverse events. Conclusion: The spectrum of renal function, when it was presented by GFR, is broad and is an important risk predictor for adverse outcomes after acute MI, even in patients with normal or mildly elevated serum creatinine concentrations. Furthermore, standard treatments were underused in any degree of renal dysfunction.

Bibliographic Details

Sang Hee Lee; Young Jo Kim; Woong Kim; Jong Seon Park; Dong Gu Shin; Seung Ho Hur; Chong Jin Kim; Myeong Chan Cho; Shung Chull Chae; Myung Ho Jeong; Taek Jong Hong; Doo Il Kim; Kee Sik Kim; Bon Kwon Koo; Byung Ok Kim; Chong Yun Rhim; Dong Hoon Choi; Dong Kyu Jin; Hyeon Cheol Gwon; In Ho Chae; In Whan Seong; Jae Young Rhew; Jang Ho Bae; Jei Keon Chae; Jeong Gwan Cho; Jin Man Cho; Jin Yong Hwang; Jong Hyun Kim; Jung Han Yoon; Ju Young Yang; Keum Soo Park; Ki Bae Seung; Kyoo Rok Han; Kyoung Tae Jeong; Moo Hyun Kim; Myoung Yong Lee; Nae Hee Lee; Seok Kyu Oh; Seong Wook Park; Seong Woon Rha; Seung Jae Joo; Seung Jea Tahk; Seung Jung Park; Soo Joong Kim; Tae Hoon Ahn; Yang Soo Jang; Young Keun Ahn; Young Youp Koh; Wook Sung Chung

Japanese Circulation Society

Medicine

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