Estimated glomerular filtration rate as one of the main predictors of in-hospital mortality in Egyptian patients with ST elevation myocardial infarction: a two-year retrospective study

Abstract

Background: Renal dysfunction is one of the major causes of in-hospital mortality in STEMI patients. In this study, we evaluated the combined predictive value of eGFR by CKD-EPI equation and shock index for in-hospital mortality and other adverse clinical outcomes in Egyptian patients with STEMI. Results: A total of 450 STEMI patients were divided into 2 groups according to their eGFR with a cutoff value of 60 ml/min/1.73 m 2 and compared as regards mortality, major bleeding, reinfarction, development of heart failure, stroke, and atrial fibrillation during the period of admission. Univariate analysis was performed to define significant factors that affected mortality; then, significant factors were subjected to a multivariate logistic regression. Patients with eGFR < 60 ml/min/1.73 m 2 had higher rates of mortality (P < 0.0005) and atrial fibrillation (P = .006) during the hospital admission. A multivariate logistic regression model showed the predictors of mortality were factors SI (OR = 28.56, 95% CI 8-101.97, P < 0.0001), cardiac troponin (OR = 2.89, 95% CI 1.08-7.77, P = 0.03), age (OR = 1.07, 95% CI 1.02-1.2, P = 0.002), and eGFR (OR = 0.98, 95% CI 0.96-0.99, P = 0.04). Conclusions: Estimated GFR < 60 ml/min/1.73 m 2 in STEMI patients is associated with higher rate of mortality. Estimated GFR, age, shock index, and cardiac troponin were the most significant predictors of mortality in STEMI patients

Length of Stay and Short-Term Outcomes in Patients with ST-Segment Elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention: Insights from the China Acute Myocardial Infarction Registry

“…Previous studies have demonstrated prognostic value of renal function in patients with STEMI. [26][27][28] In present study, we found no significant impact of chronic renal dysfunction or creatinine on LOS. Interestingly, although numerous studies proved more advantages of transradial approach than transfemoral access in percutaneous coronary intervention (PCI), 29 even for STEMI patients with cardiogenic shock, 30 transradial approach was not an independent associated factor of LOS in this analysis.…”

Impact of Baseline Estimated Glomerular Filtration Rate Using CKD-EPI Equation on Long-term Prognosis of STEMI Patients: A Matter of Small Increments!

“…The proportion of underlying risk factors often increase along with declining GFR according to most prior studies, which was in agreement with our findings. 15–19 Thus, by shifting from normal toward severely decreased GFR, we observed a gradual increase in frequency of diabetes, former MI, prior cerebrovascular disease, hypertension, dyslipidemia, and advanced Killip class. Conversely, the male predominance decreases and the prevalence of current smoking falls as well.…”

“…Several studies have demonstrated a lower likelihood of in-hospital mortality in STEMI patients having normal renal function compared against those with decreased GFR, which is relatively close to our findings. 11,12, 15–19 These articles have categorized baseline GFR in agreement with our classification. However, some of them employed the MDRD equation 12,15,16 instead of the CKD-EPI, discussed here.…”

“…Similarly, current body of evidence supports the robust connection of baseline estimated GFR and long-term adverse events including all-cause mortality and MACE. [11][12][13][14][15][16][17][18][19] There is a common paradigm of treatment-risk contradiction observed in majority of the studies pertaining to STEMI patients suffering from CKD or impaired renal function. The mentioned paradox describes relatively lower rates of aggressive reperfusion methods such as primary PCI, as well other approved optimal treatments in patients with renal dysfunction.…”

“…Similarly, current body of evidence supports the robust connection of baseline estimated GFR and long-term adverse events including all-cause mortality and MACE. 11–19…”