Abstract 2836: Mild Decline in Renal Function, though Creatinine Clearance is within Normal Level, is Closely Associated with Poor Prognosis after Myocardial Infarction
Background; Renal insufficiency is a predictor of poor prognosis after myocardial infarction (MI), but it remains unknown whether mild decline in renal function is associated with worsening of prognosis in MI patients.
Aim; To evaluate the impact of mild decline in renal function on the prognosis of patients with MI.
Method; We studied consecutive 2252 patients with acute MI enrolled in multi-center registry trial, named OACIS. We measured serum creatinine at day-1 and calculated creatinine clearance (CCR) using Cockcroft-Gault equation. Patients were divided into quartiles based on CCR. Average follow-up period was 366 days.
Result; Total and cardiac mortalities during follow-up were 9.8% and 5.2%, respectively. With a decrease in CCR, the mortality increased (Table 1⇓). Even in those with apparently normal renal function (Q1 and Q2), the mortality was significantly higher in Q2. Cox regression analysis revealed increase in CCR quartile, heart failure on admission, primary PCI and LV dysfunction (EF<40%) were the independent predictors of total mortality (Table 2⇓).
Conclusion; With a decrease in CCR, even in the normal range of CCR, total and cardiac mortalities increase among the patients with MI. Mild decline in renal function is associated with poorer prognosis in MI patients.