Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea.
Cardiol J. 2013;20(5):526-32. doi: 10.5603/CJ.2013.0138.
A limited number of studies have investigated the impact of gender on renal function and clinical outcomes after ST-segment elevated myocardial infarction (STEMI), and these studies have provided discrepant results.
This study was based on a retrospective cohort, the Korean Acute Myocardial Infarction Registry (KAMIR). Patients (n = 7,679) with a discharge diagnosis of STEMI were analyzed to investigate association of gender with renal function and clinical outcomes. Compared to men, women were older and exhibited more comorbidity, including impaired renal function. Women showed higher mortality compared to men (1-month mortality,5.6% in men vs. 12.6% in women, p < 0.001; 1-year mortality, 6.8% in men vs. 14.4% in women, p < 0.001). The risk of death proportionally increased as estimated glomerular filtration rate (eGFR) decreased in both genders. After adjusting for potential confounders, hazard ratios for women did not significantly differ from those for men at each eGFR level.The interaction test showed no significant interaction between gender and eGFR in 1-month mortality and 1-year mortality.
Impaired renal function was an independent prognostic factor after STEMI in both genders, and the impact of impaired renal function on prognosis after STEMI did not significantly differ between genders.
少数研究探讨了性别对 ST 段抬高型心肌梗死（STEMI）后肾功能和临床结局的影响，这些研究结果存在差异。
本研究基于回顾性队列研究，即韩国急性心肌梗死注册研究（KAMIR）。分析了诊断为 STEMI 的患者（n = 7679），以探讨性别与肾功能和临床结局的关系。与男性相比，女性年龄更大，合并症更多，包括肾功能受损。与男性相比，女性死亡率更高（1 个月死亡率：男性为 5.6%，女性为 12.6%，p < 0.001；1 年死亡率：男性为 6.8%，女性为 14.4%，p < 0.001）。在两性中，随着估算肾小球滤过率（eGFR）的降低，死亡风险呈比例增加。在调整了潜在混杂因素后，女性的死亡风险比在每个 eGFR 水平上与男性无显著差异。交互检验显示，在 1 个月死亡率和 1 年死亡率方面，性别与 eGFR 之间无显著交互作用。
在 STEMI 后，肾功能受损是两性的独立预后因素，肾功能受损对 STEMI 后预后的影响在两性之间无显著差异。
