Renal dysfunction is an independent predictor of in-hospital mortality in patients with ST-segment elevation myocardial infarction treated with primary angioplasty.

BACKGROUND: Patients with baseline renal dysfunction (BRD) have an increased cardiovascular risk and a worse prognosis after an acute myocardial infarction (AMI). Besides, the appearance of worsening renal failure (WRF) after an AMI is an independent predictor of worse prognosis too. The aim of the present study was to determine the in-hospital prognostic significance of BRD and WRF in patients with ST-segment elevation myocardial infarction (STEMI) who underwent successful primary angioplasty (PA).
METHODS: Seventy-six consecutive patients with STEMI diagnosis were admitted to our department and treated with PA successfully. Two groups were established in relation to the presence of BRD on admission (defined by a ClCr<60 ml/min/1.73 m2, estimated by the modification of diet in renal disease equation). We compared their baseline characteristics and their in-hospital mortality and developing of WRF.
RESULTS: BRD was associated to a greater in-hospital mortality (11.5% vs. 2.7%, p=0.009) and a higher incidence of WRF (12.2% vs. 2.5%, p<0.001). After adjusting by confounding factors, the multiple logistic regression analysis demonstrated that BRD was an independent predictor of in-hospital mortality (OR 2.5, CI 95% 1.5-3.8, p<0.001). Besides, WRF was associated to a greater in-hospital mortality too, independent of the presence of BRD (OR 1.9, CI 95% 1.3-2.4, p<0.001).
CONCLUSIONS: BRD was an independent predictor of in-hospital mortality in patients with STEMI who underwent successful PA. Likewise, WRF occurring in these patients was an independent predictor of in-hospital mortality too.