Naslov
Acute renal failure complicating first myocardial infarction : the impact on infarct course and in-hospital mortality

Autori
Madžar, Željko ; Zaputović, Luka ; Čubranić, Zlatko ; Miškulin, Rajko ; Marinović, Đuro ; Plazonić, Željko ; Padovan, Marijan

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Abstracts of the XXIV Congress of the European Society of Cardiology ; u: European Heart Journal. Abstract Supplement 23 (2002) (S) / - , 2002, S583-S583

Skup
Congress of the European Society of Cardiology (24 ; 2002)

Mjesto i datum
Berlin, Njemačka, 31.08.2002. - 04.09.2002

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
acute renal failure; acute myocardial infarction; prognosis; mortality

Sažetak
Acute renal failure (ARF) is a major cause of in-hospital morbidity and mortality, usually indicating the serious nature of the underlying disease. ARF complicates approximately 5% of hospital admissions and up to 30% of admissions to intensive care units. The aim of this study was to investigate the incidence of ARF in patients with first acute myocardial infarction (AIM), reveal the influencing factors and assess it's impact on infarct course and final outcome. We analysed renal function in 583 patients with first AMI (363 or 62.3% male, mean age 66.7&#177; ; 12.9 years), admitted to our Coronary Care Unit from January 1, 2000 to June 2001. Diagnosis of ARF was based on serum creatinine levels, i.e. acute increase in creatinine from normal to above 180 micromol/L, or it's rise from baseline values for 50% or more in patients with previous mild or moderate renal failure. In 58 (9.9%) patients (34 male, 24 female, mean age 74.9&#177; ; 8.1 years) AMI was complicated with ARF. The causes of ARF were acute heart failure (31 pts, 53.5%), adverse drug effects (7 pts, 12.1%), transient hypotension due to volume depletion (5 pts, 8.6%), or combination of the previous causes (15 pts, 25.8%). ARF occurred more frequently in patients over 65 years (13.6% vs. 3.3%, p<0.05), diabetics (36.5% vs. 13.6%, p<0.05), hypertensive patients (12.9% vs. 4.5%, p<0.05) and those with acute heart failure (22.1% vs. 4.7%, p<0.05). Patients with ARF complicating first AMI had longer hospitalisation (19&#177; ; 12 vs. 12&#177; ; 5 days, p<0.05) and higher mortality rate (50.0% vs. 11.2%, p<0.05). Significant difference in mean maximal serum creatinine existed between 25 oliguric (43%) and 33 non-oliguric (57%) ARF patients (283&#177; ; 87 vs. 205&#177; ; 45 micromol/L, p<0.05). When compared to non-oliguric group, oliguric patients recovered renal function to baseline creatinine levels less frequently (8.0% vs. 57.6%, p<0.05), and had the highest mortality rate (76.0% vs. 30.3%, p<0.05). The results indicate that ARF in first AMI occurs more frequently in older population, patients with acute heart failure, diabetes mellitus and hypertension. AMI patients with ARF need prolonged hospital stay, have more serious infarct course and significantly higher mortality, especially those oliguric.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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