Abstract 12153: Prevalence and Prognostic Implications of Worsening Renal Function After Acute Myocardial Infarction
Pil-Sang Song, Jin-Ok Jeong- Physiology (medical)
- Cardiology and Cardiovascular Medicine
Introduction: Limited data exist on the association between longitudinal changes in renal function and long-term clinical outcomes in patients who survive acute myocardial infarction (AMI) events.
Hypothesis: We sought to investigate the relationship between worsening renal function (WRF) at one-year follow-up and clinical outcomes at three years after AMI.
Methods: We analyzed data from 13,104 patients enrolled in the national AMI registry from November 2011 to December 2015. Patients with all-cause death, recurrent myocardial infarction (re-MI), and re-hospitalization for heart failure (rHHF) at one-year follow-up after AMI were excluded. A total of 6,235 patients were extracted and divided into WRF and non-WRF groups. WRF was defined as a ≥25% decrease in estimated glomerular filtration rate (eGFR) from baseline to one-year follow-up. The primary outcome was three-year major adverse cardiac events (MACE), a composite of all-cause death, re-MI, and rHHF.
Results: On average, a -1.5 ml/min/1.73 m 2 /year rate of decline in eGFR was exhibited, and 575 (9.2%) patients exhibited WRF at one-year follow-up. After multiple adjustments, WRF at one-year follow-up was independently associated with increased risks of MACEs (adjusted hazard ratio: 1.498, 95% confidence interval: 1.113-2.016, P =0.01), all-cause death, and re-MI at three-year follow-up (Figure 1). Older age, female, diabetes, hypertension, non-ST segment elevation AMI, anterior AMI, anemia, left ventricular ejection fraction <35%, and baseline eGFR <30 ml/min/1.73 m 2 were identified as independent predictors of WRF after AMI.
Conclusions: WRF at one-year follow-up after AMI intuitively seems like a risk marker indicating multiple comorbidities. Monitoring serum creatinine in patients at one-year follow-up after AMI may help to identify those who are at the highest risk and guide effective long-term therapeutics.