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. 2012 Jun;3(3):123-132.
doi: 10.4021/cr184w. Epub 2012 May 20.

Renal Dysfunction was an Independent Predictor of In-Hospital Death and Ventricular Rupture in Patients With Acute Myocardial Infarction

Masayuki Goto  1 , Eiji Oda  2 , Hirooki Matsushita  1 , Ken Takarada  1 , Makoto Tomita  1 , Atsushi Saito  1 , Koichi Fuse  1 , Satoru Fujita  1 , Yoshio Ikeda  1 , Hitoshi Kitazawa  1 , Minoru Takahashi  1 , Masahito Sato  1 , Masaaki Okabe  1 , Yoshifusa Aizawa  3
Affiliations

Renal Dysfunction was an Independent Predictor of In-Hospital Death and Ventricular Rupture in Patients With Acute Myocardial Infarction

Masayuki Goto et al. Cardiol Res. 2012 Jun.

Abstract

Background: Apart from the severity of myocardial infarction and coronary artery disease, several predictors of in-hospital death (In-HD) are suggested in patients with acute myocardial infarction (AMI).

Methods: We investigated predictors of In-HD and ventricular rupture (VR) including ventricular septal rupture (VSR) and free wall rupture (FWR) with stepwise multivariable logistic regressions in 1,042 patients admitted to our Cardiovascular Center within 48 hours from symptom onset for the first attack of AMI.

Results: In-HD, VSR, and FWR were observed in 78 cases (7.5%), 14 cases of which 13 cases were In-HD, and 13 cases of which 6 cases were In-HD, respectively. Apart from the disease severity, age and renal dysfunction (RD) defined by estimated glomerular filtration rate of lower than 60 mL/min/ 1.73 m2 were independent positive predictors of In-HD (the odds ratios (ORs) (95% confidence interval (CI)): 1.04 (1.01 - 1.06) P = 0.0069 and 5.75 (3.12 - 10.59) P < 0.0001, respectively) and hypercholesterolemia was an independent negative predictor for In-HD (OR (95% CI): 0.34 (0.17 - 0.67) P = 0.0017). After including the categories of coronary disease, ventricular rupture, and ejection fraction in predictors, RD remained an independent predictor of In-HD (OR (95% CI): 6.65 (2.67 - 16.60) P < 0.0001). Age (OR (95% CI): 1.07 (1.02 - 1.12) P = 0.0064), RD (OR (95% CI): 2.77 (1.18 - 6.49) P = 0.019), and diabetes (OR (95% CI): 2.52 (1.12 - 5.71) P = 0.026) were independent predictors of VR.

Conclusions: RD was an independent predictor of In-HD and VR in patients with initial AMI.

Keywords: Acute myocardial infarction; In-hospital death; Renal dysfunction; Ventricular rupture.

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