Irreversible deterioration of estimated glomerular filtration rate in patients with acute myocardial infarction after primary percutaneous coronary intervention

2016 ◽  
Vol 32 (4) ◽  
pp. 318-324
Author(s):  
Kenya Saji ◽  
Shigeto Namiuchi ◽  
Tadashi Sugie ◽  
Toru Takii ◽  
Atsushi Kato
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Primary Percutaneous Coronary Intervention ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Coronary Intervention ◽  
Percutaneous Coronary

scholarly journals Cystatin C-based estimated glomerular filtration rate after percutaneous coronary intervention in the prediction of inhospital mortality in acute myocardial infarction

2021 ◽  
Vol 26 (12) ◽  
pp. 4642
Author(s):  
K. V. Protasov ◽  
O. S. Donirova ◽  
E. V. Batunova
Keyword(s):  
Myocardial Infarction ◽  
Glomerular Filtration Rate ◽  
Serum Creatinine ◽  
Glomerular Filtration ◽  
Cystatin C ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Coronary Intervention ◽  
Inhospital Mortality ◽  
Percutaneous Coronary

Aim. To assess the significance of changes cystatin C-based estimated glomerular filtration rate (eGFRcys) in predicting inhospital mortality in patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).Material and methods. In 133 patients with STEMI, serum creatinine and cystatin C were determined. Creatinine clearance (CrCl) was estimated according to Cockcroft-Gault equation. Creatinine-based estimated glomerular filtration rate (eGFRcr) was assessed using the MDRD (eGFRcr_MDRD) and CKD-EPI 2009 (eGFRcr_CKD-EPI). In addition, eGFRcys and a combination of serum creatinine and cystatin C (eGFRcr-cys) was assessed using the CKD-EPI 2012 equation at admission and 24-48 hours after PCI. In the groups of deceased patients and survivors, the studied parameters were compared. Their relationship with imhospital mortality was assessed by logistic regression adjusted for acute kidney injury (AKI) and GRACE risk. To assess the informativeness of identified independent predictors, an ROC analysis was performed.Results. After PCI, serum creatinine level increased by 9,8%, cystatin C — by 38,2%. CrCl decreased by 9,0%, eGFRcr_MDRD — by 10,2%, eGFRcr_CKD-EPI — by 5,2%, eGFRcys — by 29,5%, eGFRcr-cys — by 19,3%. AKI was diagnosed in 21 people (15,8%). Among the deceased patients (n=12), compared with the survivors, serum creatinine level was higher at baseline and after PCI, cystatin C — after PCI, eGFR of any calculation method was lower, while AKI developed more often. According to multivariate regression analysis, the eGFRcr-cys after PCI and the GRACE risk score were independent predictors of the endpoint. The area under the ROC curve for eGFRcr-cys after PCI was 0,835 [0,712-0,958], while the cut-off point was 38 ml/min/1,73 m2, below which the odds ratio of developing a fatal outcome was 22,2 with a 95% confidence interval of 5,7- 86,8.Conclusion. Estimated GFR determined 24-48 h after PCI based on the combination of serum creatinine and cystatin C using the CKD-EPI 2012 equation was an independent predictor of inhospital mortality in STEMI. The cut-off point of this parameter was 38 ml/min/1,73 m2, below which the death risk increases significantly. The results indicate the viability of introducing novel methods for assessing renal function based on cystatin C to improve the quality of prediction in STEMI. 

scholarly journals Prognostic Value of Estimated Glomerular Filtration Rate 3–6 Months after Percutaneous Coronary Intervention

2020 ◽  
pp. 1-9
Author(s):  
Won Jik Lee ◽  
Dong-Bin Kim ◽  
Sung-Ho Her ◽  
Chul Soo Park ◽  
Jong-Min Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Percutaneous Coronary Intervention ◽  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Group 1

<b><i>Background:</i></b> The prognostic significance of follow-up (f/u) renal function for patients undergoing percutaneous coronary intervention (PCI) remains unknown. This study sought to investigate the prognostic implications of f/u renal function in patients undergoing PCI. <b><i>Methods:</i></b> A drug-eluting stent registry was used. We divided patients into 4 groups according to the change in the estimated glomerular filtration rate (eGFR) before PCI and 3–6 months after PCI. Patients with normal pre-PCI eGFR and f/u eGFR were assigned to group 1. Those with normal pre-PCI eGFR and abnormal f/u eGFR were assigned to group 2. Patients with abnormal pre-PCI eGFR and normal f/u eGFR were assigned to group 3. Patients with abnormal pre-PCI eGFR and f/u eGFR were allocated into group 4. <b><i>Results:</i></b> A total of 4,899 PCI patients were enrolled. The death rate in group 1, 2, 3, and 4 at 3 years was 2, 11, 4, and 9%, respectively. This showed significant differences between groups, except between groups 2 and 4. The prognosis of a group with aggravation from normal renal function was worse than that of a group with recovery from abnormal renal function. A prediction model that combines clinical risk factors and f/u eGFR has more power for predicting clinical outcomes than a combination of clinical risk factors and pre-PCI eGFR. <b><i>Conclusion:</i></b> Post-PCI eGFR was more accurate for predicting patient outcomes than pre-PCI eGFR.

Sign in / Sign up

Export Citation Format

Share Document