Effects of renal impairment on cardiac remodeling and clinical outcomes after myocardial infarction

doi:10.7150/ijms.61891

CNU IR > Pharmacy and Science > Dept. of Pharmacy > Periodical Articles > Item 310902800/34509

Please use this identifier to cite or link to this item: https://ir.cnu.edu.tw/handle/310902800/34509

Title:	Effects of renal impairment on cardiac remodeling and clinical outcomes after myocardial infarction
Authors:	Chiang, Chun-Yen Huang, Sheng-Chung Chen, Michael Shih, Jhih-Yuan Hong, Chon-Seng Wu, Nan-Chun Ho, Chung-Han Wu, Chia Chun Chen, Zhih-Cherng Chang, Wei-Ting
Contributors:	Chi Mei Med Ctr, Dept Internal Med, Div Cardiol Chung Hwa Univ Med Technol, Dept Optometry Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr Chi Mei Med Ctr, Dept Surg, Div Cardiovasc Surg Chia Nan Univ Pharm & Sci, Dept Pharm Chi Mei Med Ctr, Dept Hosp & Hlth Care Adm Chi Mei Med Ctr, Dept Internal Med, Div Nephrol Southern Taiwan Univ Sci & Technol, Dept Biotechnol Natl Cheng Kung Univ, Coll Med, Inst Clin Med
Keywords:	myocardial infarction cardiac remodeling renal function mortality heart failure
Date:	2021
Issue Date:	2023-11-11 11:59:57 (UTC+8)
Publisher:	IVYSPRING INT PUBL
Abstract:	How renal function influences post-acute myocardial infarction (AMI) cardiac remodeling and outcomes remains unclear. This study evaluated the impact of levels of renal impairment on drug therapy, echocardiographic parameters, and outcomes in patients with AMI undergoing percutaneous coronary intervention (PCI). A total of 611 patients diagnosed with AMI underwent successful PCI, and two echocardiographic examinations were performed within 1 year after AMI. Patients were categorized according to Group 1: severely impaired estimated glomerular filtration rate (eGFR)<30, Group 2: mildly impaired 30<_eGFR<60, Group 3: potentially at risk 60<_eGFR<90 and normal eGFR >= 90 ml/min/1.73 m2. During the 5-year follow-up period, the primary endpoints were cardiovascular mortality and outcomes. Patients with worse renal function (eGFR<30) were older and had a higher prevalence of hypertension and diabetes, but relatively few were smokers or had hyperlipidemia. Despite more patients with lesions of the left anterior descending artery, those with worse renal function received suboptimal guideline-directed medical therapy (GDMT). Notably, patients with worse renal function presented with worse left ventricular function at baseline and subsequent follow-up. Kaplan-Meier analysis revealed increased cardiovascular death, development of heart failure, recurrent AMI and revascularization in patients with worse renal function. Notably, as focusing on patients with ST elevation MI, the similar findings were observed. In multivariable Cox regression, impaired renal function showed the most significant hazard ratio in cardiovascular death. Collectively, in AMI patients receiving PCI, outcome differences are renal function dependent. We found that patients with worse renal function received less GDMT and presented with worse cardiovascular outcomes. These patients require more attention.
Relation:	INT J MED SCI, v.18, n.13, pp.2842-2848
Appears in Collections:	[Dept. of Pharmacy] Periodical Articles

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