Renal Insufficiency is Related to Painless Myocardial Infarction

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Author(s)

    • KOMUKAI Kimiaki
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • OGAWA Takayuki
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • YAGI Hidenori
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • DATE Taro
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • SUZUKI Kiyofumi
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • SAKAMOTO Hiroshi
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • MIYAZAKI Hidekazu
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • TAKATSUKA Hisashi
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • SHIBAYAMA Kenri
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • OGAWA Kazuo
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • KANZAKI Yasuko
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • KOSUGA Tsuneharu
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • KAWAI Makoto
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • HONGO Kenichi
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • YOSHIDA Satoru
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • TANIGUCHI Ikuo
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine
    • MOCHIZUKI Seibu
    • Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine

Abstract

<b>Background</b> Acute myocardial infarction (MI) sometimes occurs without painful symptoms and in such cases, prognosis is worsened by delays in diagnosis and revascularization. Renal insufficiency induces many types of neuropathy, but the relation between renal insufficiency and painless MI remains unclear. <b>Methods and Results</b> Patients with MI and elevated creatine kinase levels were retrospectively analyzed. Renal insufficiency (serum creatinine concentration ≥1.5 mg/dl) and other characteristics (age, sex, body mass index, hypertension, smoking, diabetes mellitus, dyslipidemia, history of stroke, previous MI, hemodialysis, and atrial fibrillation) were compared between patients who had MI with painful symptoms (painful MI, n=131) and patients who had MI without painful symptoms (painless MI, n=18). Other variables compared were the time from symptom onset to admission, peak creatine kinase concentration, Killip class, site of MI, emergency coronary angiography, postprocedural Thrombolysis In Myocardial Infarction grade III flow, and in-hospital death. Univariate analysis identified older age, renal insufficiency, and previous MI as predictors of painless MI. Patients with painless MI showed higher rates of Killip class ≥II and in-hospital death and a longer time from symptom onset to admission. However, multivariate analysis identified only renal insufficiency as an independent predictor of painless MI. <b>Conclusions</b> MI without painful symptoms frequently develops in patients who have renal insufficiency, so the possibility of painless MI should be evaluated in such patients to ensure early diagnosis and treatment. (<i>Circ J</i> 2007; <b>71:</b> 1366 - 1369)<br>

Journal

  • Circulation Journal

    Circulation Journal 71(9), 1366-1369, 2007-08-20

    Japanese Circulation Society

References:  20

Cited by:  5

Codes

  • NII Article ID (NAID)
    110006399679
  • NII NACSIS-CAT ID (NCID)
    AA11591968
  • Text Lang
    ENG
  • Article Type
    Journal Article
  • ISSN
    13469843
  • Data Source
    CJP  CJPref  NII-ELS  J-STAGE 
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