Research Paper Advance Articles

Association between renal function impairment and multivessel involvement in patients with acute ST-elevation myocardial infarction

Rei-Yeuh Chang1,2,3, , Han-Lin Tsai1, , Malcolm Koo4,5, , How-Ran Guo6,7, ,

  • 1 Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi City, Taiwan
  • 2 Chung Jen Junior College of Nursing, Health Sciences and Management, Chiayi County, Taiwan
  • 3 Min-Hwei Junior College of Health Care Management, Tainan City, Taiwan
  • 4 Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Taiwan
  • 5 Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  • 6 Department of Environmental and Occupational Health, National Cheng Kung University, Tainan City, Taiwan
  • 7 Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan

Received: November 18, 2019       Accepted: May 1, 2020       Published: May 20, 2020      

https://doi.org/10.18632/aging.103299
How to Cite

Copyright © 2020 Chang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

The aim of this study was to evaluate the association between acute ST-elevation myocardial infarction (STEMI) involving multivessel and the severity of renal function impairment. We reviewed medical records of patients with acute STEMI admitted to a regional teaching hospital in southern Taiwan between March 1999 and October 2013. A total of 1215 patients who underwent coronary angiography were included. Multiple logistic regression analysis showed that multivessel involvement (at least two) with significant stenosis was significantly associated with stage 4 chronic kidney disease (adjusted odds ratio [aOR]=2.14, 95% confidence interval [CI]=1.09–4.20) and stage 5 chronic kidney disease (aOR=2.35, 95% CI=1.13–4.89), adjusting for age, sex, type 2 diabetes mellitus, hyperlipidemia, and systolic blood pressure at admission in patients with acute STEMI. In addition, multivessel total occlusion was significantly associated with stage 4 chronic kidney disease (aOR=3.68, 95% CI=1.27–10.70) and stage 5 chronic kidney disease (aOR=3.43, 95% CI=1.08–10.82), adjusting for heart rate at admission and systolic blood pressure at admission in patients with acute STEMI. In conclusion, severe renal function impairment was significantly associated with multivessel significant stenosis and multivessel total occlusion in patients with acute STEMI.

Abbreviations

AMI: acute myocardial infarction; CABG: coronary artery bypass grafting; CKD: chronic kidney disease; ESRD: end-stage renal disease; GFR: glomerular filtration rate; PCI: percutaneous coronary intervention; STEMI: ST-elevation myocardial infarction.