Archives of the Turkish Society of Cardiology
The impact of chronic kidney disease on in-hospital clinical outcomes in patients undergoing primary percutaneous angioplasty for ST-segment elevation myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(4): 276-282 | DOI: 10.5543/tkda.2011.01467

The impact of chronic kidney disease on in-hospital clinical outcomes in patients undergoing primary percutaneous angioplasty for ST-segment elevation myocardial infarction

Emre Akkaya1, Erkan Ayhan3, Hüseyin Uyarel2, Mehmet Ergelen2, Ayça Türer1, Deniz Demirci1, Duygu Demirci1, Gökhan Çiçek1, Mehmet Gül1, Zeki Günaydın1, Ahmet Narin1
1Dr. Siyami Ersek Thoracic And Cardiovascular Surgery Center, Training And Research Hospital, Cardiology Department, Istanbul, Turkey
2Balıkesir University Medical School of Medicine, Cardiology Department, Balikesir, Turkey
3Bismil State Hospital, Diyarbakir


OBJECTIVES
We investigated the effect of chronic kidney disease (CKD) on in-hospital results in patients undergoing primary percutaneous angioplasty for ST-segment elevation myocardial infarction (STEMI).

STUDY DESIGN
The study included 2,486 patients (2,070 men, 416 women) who were treated with primary angioplasty for STEMI. Of these, 273 patients (11%) were found to have CKD (glomerular filtration rate <60 ml/min/1.73 m2) before the procedure. Patients with and without CKD were evaluated with respect to demographic and clinical features, primary angioplasty findings, and in-hospital clinical results.

RESULTS
Patients with CKD exhibited a higher mean age, Killip class, and higher frequencies of female gender, diabetes, hypertension, anemia, and previous myocardial infarction (p<0.05). Angioplasty showed higher rates of right coronary artery lesion, multivessel disease, contrast nephropathy, unsuccessful procedure, and increased stenosis rate and stent length in CKD patients (p<0.05). Cardiovascular mortality occurred in 11.7% and 1.4% of patients with and without CKD, respectively (p<0.001). Patients with CKD had significantly higher incidences of target vessel revascularization, major cardiac events, stroke, cardiopulmonary resuscitation, hemodialysis, ventricular tachycardia/fibrillation, severe heart failure, cardiogenic shock, and significant hemorrhage (p<0.05). Multivariate analysis showed that CKD was an independent predictor of mortality (OR=4.1, 95% CI 1.83-9.17; p=0.001).

CONCLUSION
Our findings show that CKD patients undergoing primary angioplasty for STEMI have an increased risk profile and poorer in-hospital results, and that CKD represents an independent risk factor for mortality.

Keywords: Angioplasty, balloon, coronary, creatinine; glomerular filtration rate; hospital mortality; kidney failure, chronic; myocardial infarction/mortality; risk factors

How to cite this article
Emre Akkaya, Erkan Ayhan, Hüseyin Uyarel, Mehmet Ergelen, Ayça Türer, Deniz Demirci, Duygu Demirci, Gökhan Çiçek, Mehmet Gül, Zeki Günaydın, Ahmet Narin. The impact of chronic kidney disease on in-hospital clinical outcomes in patients undergoing primary percutaneous angioplasty for ST-segment elevation myocardial infarction. Turk Kardiyol Dern Ars. 2011; 39(4): 276-282

Corresponding Author: Erkan Ayhan, Türkiye
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