摘要
Abstract
Objective To investigate the impact of glomerular filtration rate ( GFR) on prognosis in patients with aute myocardial infarction ( AMI ) accepted primary percutaneous coronary intervention ( PCI ) . Methods A total of 118 AMI patients who were hospitalized in Department of Cardiology of Liuzhou General Hospital from June 2011 to July 2013 and met inclusion criteria were enrolled in the study .They were divided into normal estimated glomerular filtration rate ( eGFR ) group〔eGFR≥90.0 ml・ min-1・ ( 1.73 m2 ) -1 , n=56〕 and low eGFR group 〔eGFR<90.0 ml・ min-1・ ( 1.73 m2 ) -1 , n=62〕 according to chronic kidney disease classification issued by the National Kidney Foundation .The general characteristics including gender, age, smoking, body mass index, hypertension, diabetes mellitus, hyperlipidemia, serum creatinine, Killip class, serum cardiac troponin Ⅰand eGFR on admission , and left ventricular ejection fraction in 3 d were recorded.Results of coronary angiography including infarct related artery ( IRA) and coronary artery disease ( number of coronary artery disease , and whether combined left main coronary artery disease ) were recorded .All the patients were given regular follow -up after PCI.Incidence of major cardiovascular events ( MACE) including target vessel revascularization , non-fatal myocardial infarction and cardiac death was observed .Results There was no statistically significant difference in gender , smoking , body mass index , hypertension, diabetes mellitus, hyperlipidemia, Killip class, serum cardiac troponin Ⅰ and left ventricular ejection fraction between the two groups ( P>0.05) .But the age and serum creatinine in normal eGFR group were lower than those in low eGFR group (P<0.05) .There was no statistically significant difference in infarct -related artery (IRA), coronary lesion and left main trunk disease between the two groups ( P>0.05 ) .There was no statistically significant difference in incidence of target vessel revascularization , non -fatal myocardial infarction and cardiac death respectively between the two groups ( P>0.05 ) .However, incidence of total MACE in low eGFR group was significantly higher than that in normal eGFR group ( P<0.05) .Cumulative MACE-free survival rate in low eGFR group was lower than that in normal eGFR 〔RR=3.323, 95%CI (1.452, 6.820 )〕 group ( P <0.05 ) .Cox proportional hazard regression model analysis showed that age 〔RR =1.564, 95%CI (1.059, 2.431)〕, diabetes mellitus 〔RR=3.916, 95%CI (1.874, 7.215)〕 and decreased eGFR 〔RR=3.323, 95%CI (1.452, 6.820)〕 were influencing factors for MACE after adjustment of other factors ( P<0.05 ) .Conclusion Decreased eGFR in AMI patients with normal serum creatinine is associated with adverse prognosis after primary PCI and serves as an independent predictor for MACE .关键词
心肌梗死/肾小球滤过率/预后/血管成形术, 气囊, 冠状动脉Key words
Myocardial infarction/Glomerular filtration rate/Prognosis/Angioplasty, balloon, coronary分类
医药卫生
