The Impact of Renal Dysfunction on Outcomes of In-Hospital and Remote Periods in Patients With ST-Elevation Myocardial Infarction Combined With Type 2 Diabetes Mellitus

• Published in: Kardiologiia Vol. 55; no. 11; p. 24
• Main Authors: Karetnikova, V N, Evseeva, M V, Zykov, M V, Bykova, U S, Kalaeva, V V, Shafranskaya, K S, Kashtalap, V V, Gruzdeva, O V, Barbarash, O L
• Format: Journal Article
• Language: Russian
• Published: Russia (Federation) 01.01.2015
• Subjects: Acute Coronary Syndrome; Angioplasty, Balloon, Coronary; Diabetes Mellitus, Type 2; Female; Hospital Mortality; Humans; Kidney Diseases; Male; Middle Aged; Myocardial Infarction
• DOI: 10.18565/cardio.2015.11.24-30
• ISSN: 0022-9040

PURPOSE. To elucidate association of renal dysfunction (RD) with unfavorable outcomes of in-hospital and long-term (1 year) treatment stages of patients with ST-elevation (STE) myocardial infarction (M) and concomitant diabetes mellitus (DM). We enrolled in this register study 954 patients (65% men, 35% women, mean age 63.4 [62.6-64.2] years) with STE acute coronary syndrome. Mean age of men was 60.3 (59.4-61.1), of women--69.2 [68.1-70.4] years. DM was verified in 175 patients (18.3%) basing on history data and values of fasting and postprandial glycaemia. Glomerular filtration rate (GFR) was calculated by MDRD formula using serum creatinine level determined at admission. Four groups of patients were distinguished depending on the presence of DM and RD: with DM and RD (n = 82), with DM without RD (n = 93), without DM with RD (n = 269) and without DM and RD (n = 510). Presence of RD in acute period of MI was associated with 3.3-fold increase of risk of in-hospital and annual mortality, while the presence of DM was associated with 1.6-fold increase of in-hospital mortality without significant impact on annual mortality. RD had a significant impact on realization of poor outcomes in STEMI patients with concomitant DM. Prognostic significance of combination of DM and RD was proved to be higher than that of isolated DM.