Kanic Vojko, Suran David, Vollrath Maja, Tapajner Alojz, Kompara Gregor
University Medical Center Maribor, Maribor, Slovenia.
Herzzentrum Leipzig, Leipzig, Germany.
J Interv Cardiol. 2017 Oct;30(5):473-479. doi: 10.1111/joic.12407. Epub 2017 Jul 20.
Our aim was to assess the possible impact of a deterioration of renal function (DRF) not fulfilling the criteria for acute kidney injury after percutaneous coronary intervention (PCI) on outcome in patients with ST-elevation myocardial infarction (STEMI) on 30-day and long-term outcomes.
Data is lacking on the influence of DRF after PCI on outcome in patients with STEMI.
The present study is an analysis of 2572 STEMI patients who underwent PCI. The group with DRF (1022 patients) and the group without DRF (1550 patients) were compared. Thirty-day and long-term all-cause mortality were observed. Data was analyzed using descriptive statistics.
Similar mortality was observed in both groups at day 30 (4.2% patients with DRF died vs 3.2% without DRF; ns) but more patients had died in the DRF group (18.9% patients with DRF vs 14.0% without DRF; P = 0.001) by the end of the observation period. After adjustments, DRF did not independently predict long-term mortality. Age more than 70 years, bleeding, hyperlipidemia, renal dysfunction on admission, anemia on admission, diabetes, PCI of LAD, the use of more than 200 mL contrast, but not DRF after PCI, were identified as independent prognostic factors for increased long-term mortality. Renal dysfunction, bleeding, contrast >200 mL, hyperlipidemia, age >70 years, anemia, and PCI LAD predicted DRF.
DRF identified patients at increased risk of higher long-term mortality but was not independently associated with mortality.
我们的目的是评估经皮冠状动脉介入治疗（PCI）后肾功能恶化（DRF）但未达到急性肾损伤标准对ST段抬高型心肌梗死（STEMI）患者30天和长期预后的可能影响。
关于PCI后DRF对STEMI患者预后的影响的数据尚缺乏。
本研究对2572例行PCI的STEMI患者进行了分析。比较了DRF组（1022例患者）和无DRF组（1550例患者）。观察30天和长期全因死亡率。使用描述性统计分析数据。
两组在30天时观察到相似的死亡率（DRF组4.2%的患者死亡，无DRF组为3.2%；无显著性差异），但在观察期结束时，DRF组死亡的患者更多（DRF组18.9%的患者死亡，无DRF组为14.0%；P = 0.001）。调整后，DRF不能独立预测长期死亡率。年龄超过70岁、出血、高脂血症、入院时肾功能不全、入院时贫血、糖尿病、左前降支PCI、使用超过200 mL造影剂，但不包括PCI后DRF，被确定为长期死亡率增加的独立预后因素。肾功能不全、出血、造影剂>200 mL、高脂血症、年龄>70岁、贫血和左前降支PCI可预测DRF。
DRF可识别长期死亡率较高风险增加的患者，但与死亡率无独立相关性。
