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Am J Med Sci. 2013 Feb;345(2):104-11. doi: 10.1097/MAJ.0b013e318258f482.

Estimated glomerular filtration rate as a useful predictor of mortality in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention.

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Department of Internal Medicine, Division of Cardiology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.



This study evaluated the impact of estimated glomerular filtration rate (eGFR) on 30-day and 1-year mortalities in patients with an acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).


Between January 2002 and November 2009, 1432 consecutive patients who had experienced STEMI with an onset of chest pain <12 hours of undergoing primary PCI were prospectively enrolled. Patients were categorized into group 1 (eGFR <30 mL/min/1.73 m(2)), group 2 (eGFR = 30-60 mL/min/1.73 m(2)) and group 3 (eGFR >60 mL/min/1.73 m(2)).


The incidence of a high Killip class (defined as class ≥3) upon presentation, a requirement for mechanical ventilatory support for respiratory failure and intra-aortic balloon pump support for hemodynamic instability, and duration of hospitalization were substantially higher in group 1 than in groups 2 and 3, and notably higher in group 2 compared with group 3 (all P < 0.001). Conversely, the procedural success of primary PCI was remarkably lower in group 1 compared with groups 2 and 3, and it was also notably lower in group 2 than in group 3 (all P < 0.001). Additionally, both 30-day and 1-year mortalities were markedly increased in group 1 than in groups 2 and 3, and significantly higher in group 2 than in group 3 (all P < 0.001). Multivariate analysis showed that eGFR <30 mL/min/1.73 m(2) was a significantly independent predictor of 30-day and 1-year mortalities (all P < 0.001).


eGFR <30 mL/min/1.73 m(2) was strongly and independently predictive of poor short-term and long-term prognostic outcomes in patients with STEMI undergoing primary PCI.

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