Literature DB >> 17195964

The impact of renal insufficiency on patients' outcomes in emergent angioplasty for acute myocardial infarction.

Abid R Assali1, David Brosh, Itsik Ben-Dor, Alejandro Solodky, Shmuel Fuchs, Igal Teplitsky, Ran Kornowski.   

Abstract

BACKGROUND: Renal insufficiency (RF) was shown to be associated with a worsened prognosis following acute myocardial infarction (AMI).
OBJECTIVES: The authors analyzed the outcomes of AMI patients with impaired renal function tests treated using primary percutaneous coronary intervention (PCI), to determine factors associated with increased mortality risk.
METHODS: This study included 558 consecutive AMI patients treated using primary PCI between January 2001 and June 2005. The authors compared outcome results according to glomerular filtration rate (GFR). An abbreviated equation was used to calculate GFR. Patients were grouped as follow: normal (> or =90 mL/min/1.73 m(2)), mildly impaired (60-89 mL/min/1.73 m(2)), moderately impaired (30-59 mL/min/1.73 m(2)), and severely impaired GFR (< 30 mL/min/1.73 m(2)).
RESULTS: There was a stepwise increase in 30-day mortality among patients with normal, mildly, moderately, and severely impaired RF: 2.1%, 3.7%, 8.2%, and 22.2%, respectively (P = 0.004). Seventeen out of the 324 with any degree of RF died within 1 month [5.3%] of these nine patients [53%] died because of cardiac cause. Univariate correlation analysis, factors associated with an increased risk of 1 month mortality included: age > 75 years, left ventricular ejection fraction < 35%, lower GFR, killip class > 1, multivessel coronary artery disease, failure to achieve TIMI flow grade = 3, the occurrence of no-reflow, IABP use, lack of administration of anti GP 2b/3a. The amount of contrast media used during the procedure [mL/Kg] as well as renal function deterioration were also associated with increased mortality.
CONCLUSIONS: Clinical and angiographic parameters collected before and during PCI can be used to predict 30-day mortality among AMI patients with RF. Findings indicate that in the setting of contemporary catheter-based reperfusion strategy for AMI, the extent of coronary artery disease, measures of PCI complexity, and degree of renal impairment prior/following the procedure are altogether related to mortality. (c) 2006 Wiley-Liss, Inc.

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Mesh:

Year:  2007        PMID: 17195964     DOI: 10.1002/ccd.20939

Source DB:  PubMed          Journal:  Catheter Cardiovasc Interv        ISSN: 1522-1946            Impact factor:   2.692


  6 in total

Review 1.  Multivessel versus culprit-only revascularization: one time versus staged procedures for the ACS population.

Authors:  Pablo Codner; Ran Kornowski
Journal:  Curr Cardiol Rep       Date:  2012-08       Impact factor: 2.931

2.  Network Meta-Analysis of Percutaneous Intervention-Based Revascularization Strategies for ST-Elevation Myocardial Infarction and Concomitant Multi-Vessel Disease.

Authors:  Urooj Fatima; Safi U Khan; Olabisi Akanbi; Saket Girotra; Isaac Opoku-Asare
Journal:  Cardiovasc Revasc Med       Date:  2018-08-28

3.  Renal Dysfunction on Admission Predicts No-Reflow Phenomenon in Patients Undergoing Manual Thrombus Aspiration during Primary Percutaneous Coronary Intervention.

Authors:  Baris Sensoy; Sezen Baglan Uzunget; SadikKadri Acikgoz; Nur Sensoy; Fatih Sen; Burak Acar; Uğur Canpolat; Ozcan Ozeke; Serkan Cay; Orhan Maden
Journal:  Acta Cardiol Sin       Date:  2016-03       Impact factor: 2.672

Review 4.  Staged versus One-Time Complete Revascularization with Percutaneous Coronary Intervention in STEMI Patients with Multivessel Disease: A Systematic Review and Meta-Analysis.

Authors:  Zhenwei Li; Yijiang Zhou; Qingqing Xu; Xiaomin Chen
Journal:  PLoS One       Date:  2017-01-20       Impact factor: 3.240

5.  One-Year Clinical Outcomes between Single- versus Multi-Staged PCI for ST Elevation Myocardial Infarction with Multi-Vessel Coronary Artery Disease: from Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH).

Authors:  Kye Taek Ahn; Jin Kyung Oh; Seok Woo Seong; Seon Ah Jin; Jae Hwan Lee; Si Wan Choi; Myung Ho Jeong; Shung Chull Chae; Young Jo Kim; Chong Jin Kim; Hyo Soo Kim; Myeong Chan Cho; Hyeon Cheol Gwon; Jin Ok Jeong; In Whan Seong
Journal:  Korean Circ J       Date:  2020-03       Impact factor: 3.243

6.  Association between Contrast Media Volume and 1-Year Clinical Outcomes in Patients Undergoing Coronary Angiography.

Authors:  Ying-Qing Feng; Xu-Yu He; Fei-Er Song; Ji-Yan Chen
Journal:  Chin Med J (Engl)       Date:  2018-10-20       Impact factor: 2.628

  6 in total

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