Abstract 5578: The Effect of Age and Estimated Glomerular Filtration Rate on In-Hospital Mortality Following Percutaneous Coronary Intervention for Acute Myocardial Infarction: A Report from the National Cardiovascular Data Registry
To assess the effect of estimated glomerular filtration rate (eGFR) on in-hospital mortality in young (<65 year-old), old (65– 84 year-old) and very old (≥ 85 year-old) patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Chronic kidney disease is associated with worse survival post-PCI in a variety of patient subsets. Similarly, advancing age has been associated with a worse outcome after PCI. Whether risk of death after PCI is different in various age and eGFR groups is not well known. We analyzed data collected by the National Cardiovascular Data Registry (NCDR) between February 04 and March 07 from 631 US hospitals on 169,826 PCIs performed for AMI. In a risk adjusted logistic model we estimated the odds ratio associated with different eGFR levels on in-hospital death among each age group. Younger patients had fewer comorbidities, higher eGFR, less frequent multivessel disease, higher PCI success rate and lower crude mortality than old and very old patients (p<0.0001 for all comparisons). However, the odds ratio of in-hospital death was greater (OR: 7.58, CI: 6.18 –9.29) for a young patient with eGFR<30 ml/min/1.73m2 than for an old (OR: 4.75, CI: 4.14 – 5.45) or very old patient (OR: 3.50, CI: 2.50 – 4.89) with the same degree of renal insufficiency compared to similar age patients with eGFR≥60 ml/min/1.73m2 (Figure⇓). While the impact of renal impairment is substantial in all age groups, severe reduction in eGFR is a worse prognostic factor for younger than older patients.