Prognostic Impact of Chronic Kidney Disease and Anemia at Admission on In-Hospital Outcomes After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction

Shiraishi, Jun; Kohno, Yoshio; Nakamura, Takeshi; Yanagiuchi, Takashi; Hashimoto, Shingo; Ito, Daisuke; Kimura, Masayoshi; Matsui, Akihiro; Yokoi, Hiroyoshi; Arihara, Masayasu; Hyogo, Masayuki; Shima, Takatomo; Sawada, Takahisa; Matoba, Satoaki; Yamada, Hiroyuki; Matsumuro, Akiyoshi; Shirayama, Takeshi; Kikuchi, Makoto; Furukawa, Koichi

doi:10.1536/ihj.13-367

Cited by 33 publications

(30 citation statements)

References 14 publications

(21 reference statements)

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“…4) In this study, erythrocyte creatine was measured with other hemolytic markers in patients with aortic stenosis and it was found that lactate dehydrogenase and erythrocyte creatine were significantly higher and haptoglobin was lower in patients with aortic stenosis as compared with the controls. Since patients with renal failure and recent bleeding were not included in this study, 25,26) these data indicate that high-velocity jets ejected through the narrow orifice caused intravascular hemolysis in patients with aortic stenosis.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Intravascular Hemolysis With Erythrocyte Creatine in Patients With Aortic Stenosis

et al. 2016

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SummaryChronic intravascular hemolysis has been identified in patients with cardiac valve prostheses, but only a few case reports have evaluated intravascular hemolysis in patients with native valvular heart disease. To detect intravascular hemolysis in patients with aortic stenosis, erythrocyte creatine was evaluated with hemodynamic indices obtained by echocardiography.Erythrocyte creatine, a marker of erythrocyte age, was assayed in 30 patients with aortic stenosis and 10 aged matched healthy volunteers. Peak flow velocity of the aortic valve was determined by continuous-wave Doppler echocardiography. Twenty of 30 patients with aortic stenosis had high erythrocyte creatine levels (> 1.8 µmol/g Hb) and erythrocyte creatine was significantly higher as compared with control subjects (1.98 ± 0.49 versus 1.52 ± 0.19 µmol/g Hb, P = 0.007). Peak transvalvular pressure gradient ranged from 46 to 142 mmHg and peak flow velocity ranged from 3.40 to 5.95 m/second. Patients with aortic stenosis had a significantly lower erythrocyte count (387 ± 40 versus 436 ± 42 × 10 4 µL, P = 0.002) and hemoglobin (119 ± 11 versus 135 ± 11 g/L, P < 0.001) as compared with control subjects. Erythrocyte creatine had a fair correlation with peak flow velocity (r = 0.55, P = 0.002).In conclusion, intravascular hemolysis due to destruction of erythrocytes was detected in patients with moderate to severe aortic stenosis and the severity of intravascular hemolysis was related to valvular flow velocity of the aortic valve. (Int Heart J 2016; 57: 430-433)

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Section: Discussionmentioning

confidence: 99%

Evaluation of Intravascular Hemolysis With Erythrocyte Creatine in Patients With Aortic Stenosis

et al. 2016

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“…5) Dyslipidemia was defined as a total cholesterol level ≥ 220 mg/dL or low-density lipoprotein cholesterol level ≥ 140 mg/dL or medical treatment for dyslipidemia or a history of dyslipidemia. 5,6) Diabetes mellitus was defined as a hemoglobin A1c level ≥ 6.5% (as NGSP value) or medical treatment for diabetes mellitus or a history of diabetes mellitus. 5) We also calculated the estimated glomerular filtration rate (eGFR) from the serum creatinine level, age, weight, and gender using the following formula; eGFR = 194 × Cr -1.094 × age -0.287 (male), eGFR = 194 × Cr -1.094 × age -0.287 × 0.739 (female).…”

Section: Methodsmentioning

confidence: 99%

Determinants of In-Hospital Death in Acute Myocardial Infarction With Triple Vessel Disease

et al. 2016

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SummaryCompared to acute myocardial infarction (AMI) with single vessel disease (SVD) or double vessel disease (DVD), AMI with triple vessel disease (TVD) is associated with higher mortality. The aim of this study was to identify the determinants of in-hospital death in AMI with TVD. We identified AMI patients with TVD in our tertiary medical center between January 2009 and December 2014. Baseline patient characteristics including laboratory data, echocardiograms, and coronary angiograms were collected from our hospital records. We divided our study population into a survivor group and non-survivor group. Multivariate stepwise logistic regression analysis was performed to identify the determinants of in-hospital death. A total of 138 AMI patients with TVD were identified and included as the final study population. Fifteen patients died during the hospitalization (mortality rate, 10.9%). Mean systolic blood pressure (134 ± 27 mmHg) was significantly greater in the survivor group compared with the non-survivor group (114 ± 31 mmHg) (P = 0.02). The prevalence of shock on admission was significantly less in the survivor group (15.4%) than in the non-survivor group (66.7%) (P < 0.001). Multivariate stepwise logistic regression analysis revealed that shock status on admission (OR 11.50, 95% CI 3.21-41.14, P < 0.001), the left anterior descending artery (LAD) as the infarct related artery (IRA) (OR 3.83, 95% CI 1.04-14.09, P = 0.04), and serum albumin on admission (OR 0.26, 95% CI 0.08-0.84, P = 0.02) were significantly associated with in-hospital death. In conclusion, shock status on admission, the LAD as the IRA, and a low serum albumin level were the determinants of in-hospital death in AMI patients with TVD. ( 1,2) The in-hospital mortality rates of AMI complicated with cardiogenic shock with SVD, DVD, and TVD were reported to be 32.8%, 45.1%, and 58.2%, respectively. 1) Furthermore, the long-term mortality of AMI with TVD is poorer than that with DVD.2) Although several groups studied the determinants of poor clinical outcomes in AMI with multivessel disease, 3,4) the determinants of in-hospital death in AMI with TVD have not been fully investigated. It is clinically important to identify such determinants in order to obtain a better understanding of AMI with TVD, because the mortality of AMI with TVD is the greatest among AMI.

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“…7) Additionally, anemia per se was associated with higher in-hospital mortality and poor long-term outcome in patients presenting with STEMI undergoing primary PCI. 35,36) Because of the high prevalence of these predictors in our study the mortality rate in our study was high (15.7%). This is higher than in the national cardiovascular collaboration network or the French registry which reported a short-term mortality of 3.8% and 3.4%, respectively.…”

Section: )mentioning

confidence: 55%

Comorbidities and Complications in Nonagenarians Undergoing Coronary Angiography and Intervention

et al. 2017

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SummaryElderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63.8%). Non-STEMI accounted for two-thirds of the myocardial infarctions. We found higher prevalences of previous coronary artery disease (CAD) (38%), other atherosclerotic diseases (20.4%), cardiac risk factors such as hypertension (84.3%), diabetes (49.1%), hyperlipidemia (50.9%), heart failure (42.6%), atrial fibrillation (AF) (25.0%), severe aortic stenosis (13.0%), severe mitral regurgitation (3.7%), and implantable devices (25.0%), and co-morbidities such as renal impairment (48.1%), COPD (12.0%), and previous stroke (6.5%). Three-vessel disease was present in 34.6% of the patients. The left anterior descending artery (LAD) was the most affected coronary artery (67.6%). Percutaneous coronary intervention (PCI), mostly with bare metal stents (BMS), was used to manage 54.6% of the patients, and it failed in 4 of the patients. Conservative treatment was used in 39.8% of the patients and 15.7% had no significant CAD.The incidences of vascular complications, such as bleeding (6.5%), bleeding in other organs (6.5%), blood transfusion (6.5%), in-hospital paroxysmal atrial fibrillation (7.4%), in-hospital successful reanimation (2.8%), complete heart block (5.6%), acute renal impairment (23.1%), associated infection (25.9%), cardiogenic shock (14.8%), and death (15.7%) were high.Considering the more extensive risk factors, CAD and co-morbidities, acute presentation and age per se, we believe that the reported higher rates of complications and mortality are still acceptable. (Int Heart J 2017; 58: 180-184)

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Prognostic Impact of Chronic Kidney Disease and Anemia at Admission on In-Hospital Outcomes After Primary Percutaneous Coronary Intervention for Acute Myocardial Infarction

Cited by 33 publications

References 14 publications

Evaluation of Intravascular Hemolysis With Erythrocyte Creatine in Patients With Aortic Stenosis

Evaluation of Intravascular Hemolysis With Erythrocyte Creatine in Patients With Aortic Stenosis

Determinants of In-Hospital Death in Acute Myocardial Infarction With Triple Vessel Disease

Comorbidities and Complications in Nonagenarians Undergoing Coronary Angiography and Intervention

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