Prognostic Implications of Chronic Kidney Disease on Patients Presenting with ST-Segment Elevation Myocardial Infarction with versus without Stent Thrombosis

Gilad Margolis, Shahar Vig, Nir Flint, Shafik Khoury, Michael Barkagan, Gad Keren, Yacov Shacham

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Limited data is present regarding long-term outcomes in chronic kidney disease (CKD) patients presenting with stent thrombosis (ST). We evaluated the possible implications of CKD on long-term mortality in patients presenting with ST-segment elevation myocardial infarction (STEMI) and treated with primary percutaneous coronary intervention (PCI), and its interaction with the presence of ST. Methods: We retrospectively studied 1,722 STEMI patients treated with primary PCI. Baseline CKD was categorized as an estimated glomerular filtration rate <60 mL/min/1.73 m2 at presentation. The presence of ST was determined using the Academic Research Consortium definitions. Patients were evaluated for the presence of CKD and ST, as well as for long-term mortality. Results: A total of 448/1,722 (26%) patients had baseline CKD. Patients with CKD were older and had more comorbidities and a higher rate of ST (4 vs. 7%, respectively, p < 0.001). In a univariate analysis, long-term mortality was significantly higher among those with CKD compared to those without CKD (17.6 vs. 2.7%, p < 0.001). The presence of ST did not alter long-term mortality in both CKD and no-CKD patients. In a Cox regression model, CKD was an independent predictor of long-term mortality (hazard ratio 2.04, 95% confidence interval 1.17-3.56, p = 0.01), while ST as a covariate was not significantly associated with long-term mortality. Conclusion: Among STEMI patients, CKD, but not ST, is a predictor of long-term mortality.

Original languageEnglish
Pages (from-to)150-157
Number of pages8
JournalCardioRenal Medicine
Volume7
Issue number2
DOIs
StatePublished - 1 Feb 2017

Keywords

  • Acute myocardial infarction
  • Chronic kidney disease
  • Mortality
  • Percutaneous coronary intervention
  • Stent thrombosis

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