Decreased glomerular filtration rate is a significant and independent risk for in-hospital mortality in Japanese patients with acute myocardial infarction: report from the Hokkaido acute myocardial infarction registry

摘要

Renal dysfunction is a significant risk factor in the prognosis of patients with cardiovascular diseases. We sought to determine the relationship between estimated glomerular filtration rate (eGFR) values and in-hospital mortality in Japanese acute myocardial infarction (AMI) patients. A total of 2266 consecutive AMI patients admitted to 22 hospitals in Hokkaido were registered. The eGFR values were determined using the following equation: eGFR=194x(serum creatinine)~-1.094x(age)~0.287 (x0.739 if female). Patients were classified into four groups according to their eGFR values: >=60 (n=1304), 30-59 (n=810), 15-29 (n=87) and < 15 ml min~-1 per 1.73 m~2 (n=65). A total of 110 patients (4.9%) died during hospitalization. The in-hospital mortality rate was significantly higher in patients with reduced eGFR values at 2.3, 5.4, 24.1 and 23.1% for eGFR values of >=60, 30-59, 15-29, and <15mlmin~-1 per 1.73 m~2, respectively. The odds ratios for in-hospital all cause death were 8.26 (95% confidence interval (Cl): 2.22-30.77) for eGFR<15ml min~-1 per 1.73 m~2 and 3.42 (95% Cl: 1.01-11.61) for eGFR 15-29 ml min~-1 per 1.73 m~2 compared with eGFR >=60 ml min~-1 per 1.73 m~2. Similarly, the odds ratios for in-hospital cardiac death were 8.43 (95% Cl: 1.82-39.05) for eGFR< 15 ml min~-1 per 1.73 m~2 and 5.47 (95% Cl: 1.51-19.80) for eGFR 15-29 ml min~-1 per 1.73 m~2. In conclusion, the eGFR of <30mlmin~-1 per 1.73 m~2 was a significant and independent risk for in-hospital mortality in abroad cohort of Japanese patients with AMI.