Impact of Renal Insufficiency in Patients Undergoing Primary Angioplasty for Acute Myocardial Infarction

DOI Web Site 被引用文献27件
  • H. Mehrdad Sadeghi
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Gregg W. Stone
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Cindy L. Grines
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Roxana Mehran
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Simon R. Dixon
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Alexandra J. Lansky
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Martin Fahy
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • David A. Cox
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Eulogio Garcia
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • James E. Tcheng
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • John J. Griffin
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Thomas D. Stuckey
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • Mark Turco
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...
  • John D. Carroll
    From William Beaumont Hospital, Royal Oak, Mich (H.M.S., C.L.G., S.R.D.); the Cardiovascular Research Foundation, New York, NY (G.W.S., R.M., A.J.L., M.F.); Mid Carolina Cardiology, Charlotte, NC (D.A.C.); Hospital Gregorio Maranon, Madrid, Spain (E.G.); Duke Clinical Research Institute, Durham, NC (J.E.T.); Virginia Beach General Hospital, Virginia Beach, Va (J.J.G.); Moses Cone Memorial Hospital, Greensboro, NC (T.D.S.); Center for Cardiac and Vascular Research, Tacoma Park, Md (M.T.); and the...

書誌事項

公開日
2003-12-02
DOI
  • 10.1161/01.cir.0000103623.63687.21
公開者
Ovid Technologies (Wolters Kluwer Health)

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説明

<jats:p> <jats:bold> <jats:italic>Background—</jats:italic> </jats:bold> The prognostic importance of renal insufficiency (RI) in patients undergoing primary percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been well characterized. </jats:p> <jats:p> <jats:bold> <jats:italic>Methods and Results—</jats:italic> </jats:bold> PCI was performed in 2082 AMI patients without shock presenting within 12 hours of symptom onset in a prospective, multicenter randomized trial. RI was defined as a calculated (Cockroft-Gault) creatinine clearance (CrCl) ≤60 mL/min. RI at baseline was present in 18% of patients. Compared with patients without RI, patients with RI were older and were more likely to be female; to have hypertension, peripheral vascular disease, or cerebrovascular disease; and to present in heart failure. Mortality was markedly increased in patients with versus without baseline RI both at 30 days (7.5% versus 0.8%, <jats:italic>P</jats:italic> <0.0001) and at 1 year (12.7% versus 2.4%, <jats:italic>P</jats:italic> <0.0001). Mortality rates increased incrementally for every 10-mL/min decrease in baseline CrCl. By multivariate analysis, reduced baseline CrCl was a powerful independent predictor of 30-day mortality (hazard ratio, 5.77; <jats:italic>P</jats:italic> <0.0001) and remained associated with reduced survival at 1 year (hazard ratio, 1.98; <jats:italic>P</jats:italic> =0.08). Hemorrhagic complications and transfusion requirements were also increased more than 2-fold in patients with RI, as were severe restenosis (diameter stenosis ≥70%; 20.6% versus 11.8%, <jats:italic>P</jats:italic> =0.024) and infarct artery reocclusion (14.7% versus 7.3%, <jats:italic>P</jats:italic> =0.02). </jats:p> <jats:p> <jats:bold> <jats:italic>Conclusions—</jats:italic> </jats:bold> Baseline RI in patients with AMI undergoing primary PCI is associated with a markedly increased risk of mortality, as well as bleeding and restenosis. Novel approaches are needed to improve the otherwise poor prognosis of patients with RI and AMI. </jats:p>

収録刊行物

  • Circulation

    Circulation 108 (22), 2769-2775, 2003-12-02

    Ovid Technologies (Wolters Kluwer Health)

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