Contemporary in-hospital and long-term prognosis of patients with acute ST-elevation myocardial infarction depending on renal function: a retrospective analysis.
BMC Cardiovasc Disord
; 23(1): 62, 2023 02 02.
Article
en En
| MEDLINE
| ID: mdl-36732721
ABSTRACT
BACKGROUND:
Cardiovascular disease is often associated with chronic kidney disease (CKD), resulting in an increased risk for poor outcome. We sought to determine short-term mortality and overall survival in ST-elevation myocardial infarction (STEMI) patients with different stages of CKD.METHODS:
In our retrospective cohort study with health insurance claims data of the Allgemeine Ortskrankenkasse (AOK), anonymized data of all STEMI patients hospitalized between 2010 and 2017 were analyzed regarding presence and severity of concomitant CKD.RESULTS:
A total of 175,187 patients had an index-hospitalisation for STEMI (without CKD 78.6% patients, CKD stage 1 0.8%, CKD stage 2 4.8%, CKD stage 3 11.7%, CKD stage 4 2.8%, CKD stage 5 0.7%, CKD stage 5d 0.6%). Patients with CKD were older and had more co-morbidities than patients without CKD. With increasing CKD severity, patients received less revascularization therapies (91.2%, 85.9%, 87.0%, 81.8%, 71.7%, 76.9% and 78.6% respectively, p < 0.001). After 1 year, guideline-recommended medications were prescribed less frequently in advanced CKD (83.4%, 79.3%, 81.5%, 74.7%, 65.0%, 59.4% and 53.7%, respectively, p < 0.001). CKD stages 4, 5 and 5d as well as chronic limb threatening ischemia (CLTI) were associated with decreased overall survival [CKD stage 4 hazard ratio (HR) 1.72; 95% CI 1.66-1.78; CKD stage 5 HR 2.55; 95% CI 2.37-2.73; CKD stage 5d 5.64; 95% CI 5.42-5.86; CLTI 2.06; 95% CI 1.98-2.13; all p < 0.001].CONCLUSIONS:
CKD is a frequent co-morbidity in patients with STEMI and is associated with a worse prognosis especially in advanced stages. Guideline-recommended therapies in patients with STEMI and CKD are still underused.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Insuficiencia Renal Crónica
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Infarto de la Pared Anterior del Miocardio
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Intervención Coronaria Percutánea
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Infarto del Miocardio con Elevación del ST
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
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Guideline
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Año:
2023
Tipo del documento:
Article