RRML - Renal dysfunction at hospital admission, high complexity of coronary artery disease and short term prognosis in acute ST-segment elevation myocardial infarction
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Dr. Adrian Man
   
 
Nr. 20(4)/2012
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Renal dysfunction at hospital admission, high complexity of coronary artery disease and short term prognosis in acute ST-segment elevation myocardial infarction

László Hadadi, Cristina Somkereki, Dan Dobreanu


Abstract:

Introduction: Renal dysfunction predicts worse outcomes after ST elevation myocardial infarction (STEMI), even if interventional reperfusion therapy is available. The SYNTAX score is an angiographic tool for assessing the complexity of coronary artery disease. Higher values correspond to a more affected vasculature and are associated with increased complication and mortality rates after primary percutaneous coronary inter- vention (pPCI). Kidney dysfunction is more prevalent in patients with stable coronary artery disease and high SYNTAX score values. However, this association was not prospectively studied in STEMI patients undergoing pPCI. Material and methods: All STEMI patients admitted between 2011.01.01-2011.12.31 were included in a prospective clinical study. The SYNTAX score was calculated on the basis of emergency coronary angiograms; glomerular filtration rate (GFR) was determined according to the Cockroft-Gault equation, using the serum creatinine levels measured at admission. If GFR was <60 ml/min, renal dysfunction was considered. Three different SYNTAX score tertiles were defined, with low (<11), medium (11-19.5) and high (≥20) values. Results: GFR and SYNTAX score were calculated in 135 of the 137 patients included in the study. Impaired GFR (<60ml/min) was found in 36 cases (26.6%). A negative correlation was observed between the GFR and SYNTAX score values (r=-0.2191, p=0.0107). The GFR was significantly lower in the high SYNTAX score tertile (p=0.029). In-hospital mortality was significantly increased in the high SYNTAX score group (p=0.0397), and also if renal dysfunction was present (p=0.0008). Conclusion: renal dysfunction at hospital admission for STEMI is associated with more complex coronary artery disease. Both conditions increase in-hospital mortality after pPCI.

Keywords: SYNTAX score,acute myocardial infarction,glomerular filtration rate

 
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How to cite
Hadadi L, Somkereki C, Dobreanu D. Renal dysfunction at hospital admission, high complexity of coronary artery disease and short term prognosis in acute ST-segment elevation myocardial infarction. Rev Romana Med Lab. 2012;20(4):363-9