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MINERVA CARDIOANGIOLOGICA

Rivista sulle Malattie del Cuore e dei Vasi


Official Journal of the Italian Society of Angiology and Vascular Pathology
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ORIGINAL ARTICLE  


Minerva Cardioangiologica 2018 February;66(1):6-15

DOI: 10.23736/S0026-4725.17.04506-6

Copyright © 2017 EDIZIONI MINERVA MEDICA

lingua: Inglese

Impact of chronic kidney disease on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A long-term single-center mortality study

Mattia PEYRACCHIA , Paolo SCACCIATELLA, Federico CONROTTO, Ilaria MEYNET, Lorenza M. BIAVA, Carlo BUDANO, Mauro PENNONE, Maurizio D’AMICO, Fiorenzo GAITA

Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza di Torino, Turin, Italy


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BACKGROUND: Chronic kidney disease (CKD) is associated with increased risk of mortality. We examined the impact of moderate and severe CKD at presentation on short- and long-term mortality among unselected patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PPCI).
METHODS: The study cohort consists of 501 patients (pts), enrolled from October 2005 to December 2012. The median follow-up was 46.52±25.58 months (range 8-99). A severe CKD (estimated Glomerular Filtration Rate [eGFR] <30 mL/min/1.73 m2) was detected in 16 pts (3.19%), a moderate CKD (eGFR 30-59 mL/min/1.73 m2) in 110 (21.96%) and a normal kidney function (eGFR >60 mL/min/1.73 m2) in 375 (74.85%).
RESULTS: The crude in-hospital mortality rate resulted significantly higher in pts with severe and moderate CKD compared to pts with normal renal function (50% and 19.08% versus 2.93%, P<0.0001), as well as the long-term mortality rate (57.14% and 46.34% versus 8.77%, P<0.0001). After adjustment for confounding variables, severe and moderate CKD resulted the main independent predictors of in-hospital (odds ratio [OR]=21.815, P<0.0001 for severe CKD and OR= 4.203, P=0.002 for moderate CKD) and long-term (hazard ratio [HR]= 5.272, P=0.001; HR= 1.978, P=0.006) mortality.
CONCLUSIONS: CKD is a frequent condition in patients with STEMI treated with PPCI and it is associated to an excess of mortality, resulting the main independent negative prognostic predictor.


KEY WORDS: Renal insufficiency, chronic - Angioplasty- Myocardial infarction - Mortality

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Publication History

Issue published online: December 7, 2017
Article first published online: September 25, 2017
Manuscript accepted: September 18, 2017
Manuscript received: August 17, 2017

Per citare questo articolo

Peyracchia M, Scacciatella P, Conrotto F, Meynet I, Biava LM, Budano C, et al. Impact of chronic kidney disease on mortality in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. A long-term single-center mortality study. Minerva Cardioangiol 2018;66:6-15. DOI: 10.23736/S0026-4725.17.04506-6

Corresponding author e-mail

peyracchia@gmail.com