Abstract 13369: Chronic Kidney Disease Predicts New Lesion Revascularization after Acute Myocardial Infarction
Background: Several studies have shown that chronic kidney disease (CKD) is associated with cardiovascular disease. However, the prognostic utility of CKD in patients after AMI was unclear.
Purpose: This study was undertaken to assess impact of CKD on cardiac events after AMI.
Methods: 410 patients with AMI underwent primary percutanious coronary intervention (PCI) within 24 hours after symptom onset. CKD was defined as estimated glomerular filtration rate (eGFR) of less than 60.0 ml/minute/1.73 m2 of body-surface area (stage3–5). Clinical follow-up was obtained up to 5 years. Major Adverse Cardiac Event (MACE) was defined as cardiac death, myocardial infarction (MI) and/or revascularization for new lesions.
Results: The incidence of MACE during 5 years was significantly higher in patients with CKD than in patients without CKD (32.6% vs 14.1%, p<0.001). This difference was primarily driven by higher incidence of new lesions requiring revascularization in patients with CKD (29.2% vs 13.4%, p<0.001, figure). Multivariate analysis showed that CKD was an independent predictor for MACE (OR 1.57, 95% CI: 1.15-2.15, p=0.003) and new lesions requiring revascularization (OR 1.57, 95% CI: 1.14-2.17, p=0.004).
Conclusion: These results suggest that eGFR is useful as a predictor of the progression of the non-culprit coronary lesions after AMI. Aggressive treatment after AMI should be advocated in patients with CKD.
- © 2010 by American Heart Association, Inc.