Renal Dysfunction on Admission, Worsening Renal Function, and Severity of Acute Kidney Injury Predict 2-Year Mortality in Patients With Acute Myocardial Infarction

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  • Hsieh Ming-Jer
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • Chen Yung-Chang
    Department of Nephrology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • Chen Chun-Chi
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • Wang Chun-Li
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • Wu Lung-Sheng
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine
  • Wang Chun-Chieh
    Department of Cardiology, Chang Gung Memorial Hospital, Chang Gung University College of Medicine

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Background: Recent studies have proven that initial renal dysfunction and worsening renal function during hospitalization can predict the clinical outcome of patients with acute myocardial infarction (AMI). There is limited study regarding acute kidney injury (AKI) by the RIFLE classification (Risk of renal failure, Injury to the kidney, Failure of kidney function, Loss of kidney function, and End-stage renal failure) to assess the outcome of AMI survivors. Methods and Results: During a mean follow-up period of 635.3±204.9 days, the 2-year mortality rate was 10.6% in 613 AMI patients who survived to discharge. Adjusted Cox regression analysis revealed that left ventricular dysfunction (<40%) [hazard ratio (HR), 2.83; 95% confidence interval (CI), 1.11–7.20; P=0.029], estimated glomerular filtration rate <60ml·min–1·1.73m−2 on admission (HR, 4.01; 95% CI, 1.51–10.62; P=0.005), and AKI severity by RIFLE classification during first week after hospitalization (Injury: HR, 8.11; 95% CI, 2.53–26.05; P=0.001; Failure: HR, 19.28; 95% CI, 2.24–166.26; P=0.007) were independent predictors of 2-year mortality. Conclusions: Independent of initial renal dysfunction on admission, the AKI severity by RIFLE classification may be useful in establishing the hospital discharge risk score for predicting long-term mortality in AMI patients who survive to discharge.  (Circ J 2013; 77: 217–223)<br>

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  • Circulation Journal

    Circulation Journal 77 (1), 217-223, 2013

    一般社団法人 日本循環器学会

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