Síndrome cardiorrenal como predictor de mortalidad intrahospitalaria en el síndrome coronario agudo con elevación del segmento ST / Cardiorenal syndrome as predictor of in-hospital mortality in ST-segment elevation myocardial infarction

Introducción: El síndrome cardiorrenal incluye numerosas enfermedades que afectan el corazón y el riñón y empeora el pronóstico de los pacientes con síndrome coronario agudo. Método: Se estudiaron prospectivamente 157 pacientes que ingresaron de forma consecutiva con diagnóstico de infarto agudo de miocardio con elevación del segmento ST y clase Killip>I, de enero de 2013 a diciembre de 2016, en el Hospital General Docente Camilo Cienfuegos. Se recogieron datos clínicos, de laboratorio y ecocardiográficos en relación con la presencia de síndrome cardiorrenal y se determinó la implicación pronóstica del mismo en la mortalidad intrahospitalaria a través de la regresión logística binaria. Resultados: El síndrome cardiorrenal se presentó en 52 pacientes (33,1%). La hemoglobina mostró medias inferiores en el grupo de pacientes con síndrome cardiorrenal (117,2 ± 15,3 vs. 123,3 ± 15,1; p = 0,019), al igual que la fracción de eyección del ventrículo izquierdo (34,8 ± 8 vs. 43,2 ± 10,8). Existió una correlación positiva entre la clase Killip y el aumento de la creatinina a las 48h y de esta con la fracción de eyección del ventrículo izquierdo (r = 0,166; p = 0,038). El síndrome cardiorrenal fue más frecuente en el infarto anterior extenso y resultó un predictor independiente de mortalidad (OR 4,1; IC 95% 1,2-13,9; p = 0,022). Conclusiones: El síndrome cardiorrenal en el curso de un infarto agudo del miocardio puede asociarse a una mayor mortalidad intrahospitalaria. Su detección sería de utilidad en la estratificación pronóstica del síndrome coronario agudo

Introduction: Cardiorenal syndrome includes numerous conditions affecting the heart and kidney, and is a strong predictor of cardiovascular mortality. Method: An analysis was performed on 157 consecutive patients admitted to the Coronary Care Unit of the Camilo Cienfuegos Hospital due to an ST-segment elevation myocardial infarction and heart failure, from January 2013 to December 2016. An analysis was made of the presence of cardiorenal syndrome and its relationship with epidemiological, clinical, and analytical variables, as well as complementary explorations. The relationship between cardiorenal syndrome and in-hospital mortality was assessed using binary logistical regression. Results: A total of 52 (33.1%) patients had a cardiorenal syndrome. The haemoglobin level was lower in the group of patients with cardiorenal syndrome (117.2 ± 15.3 vs. 123.3 ± 15.1, P = .019), and in left ventricular ejection fraction (34.8 ± 8 vs. 43.2 ± 10.8). A positive correlation was found between the Killip class and the increase in serum creatinine after 48 h. The serum creatinine was associated with left ventricular ejection fraction (r = 0.166; P = .038). The multivariate analysis showed that cardiorenal syndrome was an independent predictor of in-hospital mortality when adjusted for a history of ischaemic heart disease, diabetes mellitus status, atrial fibrillation, ventricular arrhythmias, left ventricular ejection fraction, age and systolic blood pressure. Conclusions: The presence of cardiorenal syndrome has an influence on the prognosis of patients who suffer a cardiorenal syndrome. Its detection could be useful in the risk stratification

Cardiorenal syndrome as predictor of in-hospital mortality in ST-segment elevation myocardial infarction. / Síndrome cardiorrenal como predictor de mortalidad intrahospitalaria en el síndrome coronario agudo con elevación del segmento ST.

INTRODUCTION: Cardiorenal syndrome includes numerous conditions affecting the heart and kidney, and is a strong predictor of cardiovascular mortality. METHOD: An analysis was performed on 157 consecutive patients admitted to the Coronary Care Unit of the Camilo Cienfuegos Hospital due to an ST-segment elevation myocardial infarction and heart failure, from January 2013 to December 2016. An analysis was made of the presence of cardiorenal syndrome and its relationship with epidemiological, clinical, and analytical variables, as well as complementary explorations. The relationship between cardiorenal syndrome and in-hospital mortality was assessed using binary logistical regression. RESULTS: A total of 52 (33.1%) patients had a cardiorenal syndrome. The haemoglobin level was lower in the group of patients with cardiorenal syndrome (117.2 ± 15.3 vs. 123.3 ± 15.1, P = .019), and in left ventricular ejection fraction (34.8 ± 8 vs. 43.2 ± 10.8). A positive correlation was found between the Killip class and the increase in serum creatinine after 48 h. The serum creatinine was associated with left ventricular ejection fraction (r = 0.166; P = .038). The multivariate analysis showed that cardiorenal syndrome was an independent predictor of in-hospital mortality when adjusted for a history of ischaemic heart disease, diabetes mellitus status, atrial fibrillation, ventricular arrhythmias, left ventricular ejection fraction, age and systolic blood pressure. CONCLUSIONS: The presence of cardiorenal syndrome has an influence on the prognosis of patients who suffer a cardiorenal syndrome. Its detection could be useful in the risk stratification.

Síndrome cardiorrenal como predictor de mortalidad intrahospitalaria en el síndrome coronario agudo con elevación del segmento ST / Introduction Cardiorenal syndrome includes numerous conditions affecting the heart and kidney, and is a strong predictor of cardiovascular mortality

Método Se estudiaron prospectivamente 157 pacientes que ingresaron de forma consecutiva con diagnóstico de infarto agudo de miocardio con elevación del segmento ST y clase Killip > I, de enero de 2013 a diciembre de 2016, en el Hospital General Docente Camilo Cienfuegos. Se recogieron datos clínicos, de laboratorio y ecocardiográficos en relación con la presencia de síndrome cardiorrenal y se determinó la implicación pronóstica del mismo en la mortalidad intrahospitalaria a través de la regresión logística binaria(AU)

Method An analysis was performed on 157 consecutive patients admitted to the Coronary Care Unit of the Camilo Cienfuegos Hospital due to an ST-segment elevation myocardial infarction and heart failure, from January 2013 to December 2016. An analysis was made of the presence of cardiorenal syndrome and its relationship with epidemiological, clinical, and analytical variables, as well as complementary explorations. The relationship between cardiorenal syndrome and in-hospital mortality was assessed using binary logistical regression(AU)