The Prognostic Value of Serum Creatinine on Admission in Fibrinolytic-Eligible Patients with Acute Myocardial Infarction View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2003-12

AUTHORS

Hans-Peter Hobbach, C. Michael Gibson, Robert P. Giugliano, Julia Hundertmark, Christel Schaeffer, Wassillij Tscherleniak, Peter Schuster

ABSTRACT

BACKGROUND: Previous studies have demonstrated that impaired renal function is associated with unfavourable outcomes in patients with acute coronary syndromes and following percutaneous coronary intervention. METHODS: We hypothesized that serum creatinine (Cr) on admission is a useful predictor of mortality in fibrinolytic-eligible patients with ST-elevation myocardial infarction (MI). Data were collected from 352 patients with ST-elevation MI, 89% of patients underwent early invasive management. RESULTS: 30-day and 6-month mortality were increased among patients with mild to moderate (Cr > 1.2-2.8 mg/dl) renal dysfunction compared to patients with normal (Cr More... »

PAGES

167-174

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1023/b:thro.0000024055.13207.50

DOI

http://dx.doi.org/10.1023/b:thro.0000024055.13207.50

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1010269657

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/15087603


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58 schema:description BACKGROUND: Previous studies have demonstrated that impaired renal function is associated with unfavourable outcomes in patients with acute coronary syndromes and following percutaneous coronary intervention. METHODS: We hypothesized that serum creatinine (Cr) on admission is a useful predictor of mortality in fibrinolytic-eligible patients with ST-elevation myocardial infarction (MI). Data were collected from 352 patients with ST-elevation MI, 89% of patients underwent early invasive management. RESULTS: 30-day and 6-month mortality were increased among patients with mild to moderate (Cr > 1.2-2.8 mg/dl) renal dysfunction compared to patients with normal (Cr <or= 1.2 mg/dl) renal function (3.4% vs. 16.1%, p < 0.001 and 4.5% vs. 19.5%, p < 0.001). After adjustment for previously identified correlates of mortality in a multiple logistic regression model, higher Cr on admission remained independently associated with increased mortality (30-day, OR 4.78, 95%CI 1.55-14.73, p = 0.006; 6-month, 3.82 (1.45-10.11), p = 0.007). The incidence of mortality was reduced among those patients with renal dysfunction that also underwent acute percutaneous coronary intervention [30-day, OR 0.13, 95%CI 0.02-1.06, p < 0.03; 6-month, 0.23 (0.05-1.07), p < 0.05]. CONCLUSION: Cr on admission is a strong and independent predictor of mortality in patients with ST-elevation MI. This association does not appear to be mediated by reduced fibrinolytic efficacy, or by higher reinfarction rates among patients with renal dysfunction. Cr on admission is a rapid and widely available marker to identify high-risk patients with ST-elevation MI that have additional improvements in survival when treated with percutaneous coronary intervention.
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