Impact of baseline renal function on long-term outcomes after acute myocardial infarction

Abstract

Introduction

The cardiac prognosis, particularly coronary, is overshadowed by the presence of chronic kidney disease, which is increasingly recognized as a major cardiovascular risk factor.

Objective

The objective of this study is to demonstrate the involvement of renal function in cardiovascular risk.

Method

Our study includes 244 patients admitted to the cardiology department of the main military hospital of Tunis for acute coronary syndrome, divided into two groups: group 1 comprises 188 patients with a glomerular filtration rate (GFR)≥ 60 mL/min, and group 2 contains 41 patients with GFR < 60 mL/min.

Results

The mean age of patients included in the study is 62.09 years with a male predominance, yielding a sex ratio of 1.65. It's noted that a history of smoking, dyslipidemia, stroke, and/or hypertension is more prevalent among patients with renal insufficiency. Patients with a GFR < 60 mL/min significantly experienced more cardiovascular events (16.1% in group 2 compared to 5.4% in group 1; P = 0.049) with a higher number of subsequent hospitalizations (53.8% had a hospital stay of more than 3 days). In multivariate analysis, renal insufficiency is an independent predictor of cardiovascular events (P = 0.05). Among patients with chronic kidney disease, a history of stroke (P = 0.037), primary angioplasty (P = 0.000), and/or coronary revascularization surgery (P = 0.016) were predictive factors of long-term major events.

Conclusion

The findings of our study confirm that baseline renal function is a potent predictor of long-term events after myocardial infarction, highlighting the need to include renal function in the assessment of cardiovascular risk and to tailor the management of patients admitted for acute myocardial infarction accordingly.