The prognostic impact of renal function decline during hospitalization for myocardial infarction

• Published in: Journal of comparative effectiveness research Vol. 10; no. 3; pp. 219 - 228
• Main Authors: Mayer, Jr, Otto, Seidlerová, Jitka, Bruthans, Jan, Opatrný, Jan, Hromádka, Milan, Jirák, Josef, Filipovský, Jan
• Format: Journal Article
• Language: English
• Published: England Future Medicine Ltd 01.02.2021
• Subjects: Angioplasty; Cardiovascular disease; Clinical medicine; coronary artery disease; Creatinine; Disease prevention; Endocrine system; glomerular filtration; Heart attacks; Heart failure; Hospitalization; Hospitals; Information systems; Kidney diseases; Laboratories; Medical imaging; Mortality; mortality risk; renal insufficiency; Standard deviation; Values; United States > US; coronary artery disease; glomerular filtration; renal insufficiency; mortality risk
• ISSN: 2042-6305; 2042-6313
• DOI: 10.2217/cer-2020-0085

We analyzed the mortality risk of myocardial infarction (MI) patients according to renal function, observed during hospitalization. Patients hospitalized for MI between 2006 and 2018 were followed (n = 5659). We divided the sample into four groups by estimated glomerular filtration (eGFR) [ml/min]: normal functions (lowest eGFR during hospitalization >60); transiently moderate insufficiency (lowest eGFR >30 and ≤60, highest >60); permanently moderate insufficiency (highest eGFR >30 and ≤60); severe insufficiency (highest and lowest eGFR ≤30). Permanently moderate renal insufficiency indicates increased 5-years all-cause mortality (hazard risk ratio: 2.27 [95% CIs: 1.87–2.75], p < 0.0001), but a similar risk was found in patients with the only transient decline of renal functions (hazard risk ratio: 2.08 [95% CIs: 1.70–2.55], p < 0.0001). Both moderate insufficiency subgroups (transient/permanent) did not statistically differ regarding mortality risk. Even just fluctuation of eGFR toward moderate insufficiency during hospitalization represents an important prognostic indicator in MI patients.