Renal Glomerular Hyperfiltration is Associated with Poor Prognosis in Acute ST-Elevation Myocardial Infarction

Abstract

Introduction:Glomerular hyperfiltration is related to several clinical conditions, such as prediabetes and prehypertension, and associated with poor prognosis in long-term follow-up. This study aims to elucidate the relationship between glomerular hyperfiltration and short-term prognosis in patients with STsegment elevation myocardial infarction (STEMI) treated by percutaneous coronary intervention (PCI).Methods:A total of 1.402 patients (24% women, n=338) who had been diagnosed with STEMI and treated by primary PCI were enrolled in the present study. Glomerular hyperfiltration was defined an estimated glomerular filtration rate (GFR) above the 95th percentile based on age- and sex-specific distributions, and a low-filtration rate was defined as an estimated GFR below the 5th percentile. GFR was assessed using the Chronic Kidney Disease Epidemiology Collaboration equation. The major adverse cardiovascular events (MACE) considered in this work included acute stent thrombosis, re-infarction, cardiogenic shock, and cardiac death within 30 days.Results:MACE was observed in 178 patients (12.6%). High and low GFRs led to higher risks of developing major cardiovascular events [odds ratio (OR): 1.92, 95% confidence interval (CI): 1.19-3.08, p<0.01 and OR: 2.50, 95% CI: 1.50-4.17, p<0.01, respectively] compared with normal GFRs. Low ejection fraction, atrial fibrillation, previous coronary artery disease, and low systolic blood pressure were other independent risk factors influencing MACE rates in the multivariable regression models.Conclusion:Glomerular hyperfiltration is independently correlated with short-term MACE rates in patients with acute STEMI treated by primary PCI.

Keywords

• glomerular hyperfiltration
• acute myocardial infarction
• prognosis