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Abstract: Objective: To investigate the relationship between renal function and clinical outcomes among patients with acute ST-segment elevation myocardial infarction (ASTEMI), who were treated with emergency percutaneous coronary intervention (PCI). Methods: 420 patients hospitalized in Peking University First Hospital, diagnosed with ASTEMI treated with emergency (PCI) from January 2001 to June 2011 were enrolled in this study. estimated glomerular filtration rate (eGFR) was used as a measure of renal function. We compared the clinical parameters and outcomes between ASTEMI patients combined renal insufficiency and the patients with normal renal function. Results: There was a significant increase in the concentrations of fibrinogen and D-Dimer (P<0.05) and a much higher morbidity of diabetes mellitus in the group of patients with chronic kidney disease (CKD; eGFR<60 ml/(min·1.73 m²)) (P<0.01). CKD (eGFR<60 ml/(min·1.73 m²)) was an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI receiving PCI therapy rapidly (P=0.032, odds ratio (OR) 4.159, 95% confidence interval (CI) 1.127–15.346). Conclusions: Renal insufficiency is an independent predictor of in-hospital mortality for patients hospitalized with ASTEMI treated with primary PCI.

[1]Anavekar, N.S., Mcmurray, J.J., Velazquez, E.J., Solomon, S.D., Kober, L., Rouleau, J.L., White, H.D., Nordlander, R., Maggioni, A., Dickstein, K., et al., 2004. Relation between renal dysfunction and cardiovascular outcomes after myocardial infarction. N. Engl. J. Med., 351(13):1285-1295.

[2]Berrocal, D.H., Cohen, M.G., Spinetta, A.D., Ben, M.G., Rojas Matas, C.A., Gabay, J.M., Magni, J.M., Nogareda, G., Oberti, P., von Schulz, C., et al., 2003. Early reperfusion and late clinical outcomes in patients presenting with acute myocardial infarction randomly assigned to primary percutaneous coronary intervention or streptokinase. Am. Heart J., 146(6):E22.

[3]Chesebro, J.H., Knatterud, G., Roberts, R., Borer, J., Cohen, L.S., Dalen, J., Dodge, H.T., Francis, C.K., Hillis, D., Ludbrook, P., et al., 1987. Thrombolysis in myocardial infarction (TIMI) trial, Phase I: a comparison between intravenous tissue plasminogen activator and intravenous streptokinase. Clinical findings through hospital discharge. Circulation, 76(1):142-154.

[4]Freeman, R.V., Mehta, R.H., Al Badr, W., Cooper, J.V., Kline-Rogers, E., Eagle, K.A., 2003. Influence of concurrent renal dysfunction on outcomes of patients with acute coronary syndromes and implications of the use of glycoprotein IIb/IIIa inhibitors. J. Am. Coll. Cardiol., 41(5):718-724.

[5]Huo, Y., Ho, W., 2007. Renal status of ACS patients under going PCI study collaboration, renal insufficiency and clinical outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention: a multi-centre study. J. Peking Univ. (Health Sci.), 39(6):624-629 (in Chinese).

[6]Kushner, F.G., Hand, M., Smith, S.C.Jr., King, S.B.3rd, Anderson, J.L., Antman, E.M., Bailey, S.R., Bates, E.R., Blankenship, J.C., Casey, D.E., et al., 2009. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update) a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J. Am. Coll. Cardiol., 54(23):2205-2241.

[7]Levy, A.S., Bosch, J.P., Lewis, J.B., Greene, T., Rogers, N., Roth, D., 1999. A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of diet in renal disease study group. Ann. Intern. Med., 130(6):461-470.

[8]Levy, A.S., Greene, T., Kusek, J.W., Beck, G.J., Group, M.S., 2002. A simplified equation to predict glomerular filtration rate from serum creatinine (abstract). J. Am. Soc. Nephrol, 11:A0828.

[9]McCullough, P.A., 2002. Cardiorenal risk: an important clinical intersection. Rev. Cardiovasc. Med., 3(2):71-76.

[10]National Center for Cardiovascular Disease, 2008. 2006 Report on Cardiovascular Diseases in China. Publishing House of Encyclopedia of China, Beijing, China, p.1 (in Chinese).

[11]National Kidney Foundation, 2002. K/DOQ1 clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification. Am. J. Kidney Dis., 39(2 Suppl. 1):S1-S266.

[12]Pitsavos, C., Kourlaba, G., Panagiotakos, D.B., Kogias, Y., Mantas, Y., Chrysohoou, C., Stefanadis, C., 2007. Association of creatinine clearance and in-hospital mortality in patients with acute coronary syndromes: the GREECS study. Circ. J., 71(1):9-14.

[13]Rabelink, T.J., Zwaginga, J.J., Koomans, H.A., Sixma, J.J., 1994. Thrombosis and hemostasis in renal disease. Kidney Int., 46(2):287-296.

[14]Schiele, F., Legalery, P., Didier, K., Meneveau, N., Seronde, M.F., Caulfield, F., Ducloux, D., Bechetoille, P., Magnin, D., Faivre, R., et al., 2006. Impact of renal dysfunction on 1-year mortality after acute myocardial infarction. Am. Heart J., 151(3):661-667.

[15]Shlipak, M.G., Heidenreich, P.A., Noguchi, H., Chertow, G.M., Browner, W.S., McClellan, M.B., 2002. Association of renal insufficiency with treatment and outcomes after myocardial infarction in elderly patients. Ann. Intern. Med., 137(7):555-562.

[16]Shlipak, M.G., Fried, L.F., Crump, C., Bleyer, A.J., Manolio, T.A., Tracy, R.P., Furberg, C.D., Psaty, B.M., 2003. Elevations of inflammatory and procoagulant biomarkers in elderly persons with renal insufficiency. Circulation, 107(1):87-92.

[17]Sjøland, J.A., Sidelmann, J.J., Brabrand, M., Pedersen, R.S., Pedersen, J.H., Esbensen, K., Standeven, K.F., Ariens, R.A., Gram, J., 2007. Fibrin clot structure in patients with end-stage renal disease. Thromb. Haemost., 98(2):339-345.

[18]Szczech, L.A., Reddan, D.N., Owen, W.F., Califf, R., Racz, M., Jones, R.H., Hannan, E.L., 2001. Differential survival after coronary revascularization procedures among patients with renal insufficiency. Kidney Int., 60(1):292-299.

[19]Wannamethee, S.G., Shaper, A.G., Lowe, G.D., Lennon, L., Rumley, A., Whincup, P.H., 2006. Renal function and cardiovascular mortality in elderly men: the role of inflammatory, procoagulant, and endothelial biomarkers. Eur. Heart J., 27(24):2975-2981.

[20]Zachee, P., Vermylen, J., Boogaerts, M.A., 1994. Hematologic aspects of end-stage renal failure, Ann. Hematol., 69(1):33-40.