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The incidence and risk factors of stroke in patients with acute myocardial infarction treated invasively and concomitant impaired renal function
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Abstract
Background: Impaired renal function is a marker of poor prognosis in patients with acutemyocardial infarction (AMI). The aim of the study was to assess the incidence and independent predictors of stroke in population of patients with AMI treated invasively and concomitant impaired renal function (IRF).
Methods: We analyzed 2,520 consecutive AMI patients admitted to our Center between 2003 and 2007 and treated with percutaneous coronary intervention. The whole population was divided into patients with IRF, defined as glomerular filtration rate < 60 mL/min/1.73 m2 or contrast induced nephropathy (IRF group, n = 933; 37.02%) and patients without IRF (control group, n = 1587; 62.98%). The IRF group was subjected to further analysis. Data onlong-term follow-up were screened to identify the patients who experienced stroke.
Results: During median of 25.5 months of follow-up 52 (2.07%) the patients experienced stroke — 33 (3.54%) in the IRF group and 19 (1.2%) patients in the control group. The risk of major adverse cardiovascular events in the IRF group, including repeated AMI (68.8 vs.14.9%, p < 0.001) and death (45.5 vs. 25.1%, p < 0.05) was significantly higher in patients with stroke. Previous stroke (HR 6.85), female gender (HR 3.13), as well as STEMI anterior (HR 2.55) were independent risk factors of stroke in this population.
Conclusions: Patients with AMI treated invasively and concomitant IRF were at higher risk of stroke occurrence in the future. Stroke was associated with poor outcome in the studied population. Independent predictors of stroke in patients with IRF and AMI treated invasively were different from commonly recognized stroke predictors.
Abstract
Background: Impaired renal function is a marker of poor prognosis in patients with acutemyocardial infarction (AMI). The aim of the study was to assess the incidence and independent predictors of stroke in population of patients with AMI treated invasively and concomitant impaired renal function (IRF).
Methods: We analyzed 2,520 consecutive AMI patients admitted to our Center between 2003 and 2007 and treated with percutaneous coronary intervention. The whole population was divided into patients with IRF, defined as glomerular filtration rate < 60 mL/min/1.73 m2 or contrast induced nephropathy (IRF group, n = 933; 37.02%) and patients without IRF (control group, n = 1587; 62.98%). The IRF group was subjected to further analysis. Data onlong-term follow-up were screened to identify the patients who experienced stroke.
Results: During median of 25.5 months of follow-up 52 (2.07%) the patients experienced stroke — 33 (3.54%) in the IRF group and 19 (1.2%) patients in the control group. The risk of major adverse cardiovascular events in the IRF group, including repeated AMI (68.8 vs.14.9%, p < 0.001) and death (45.5 vs. 25.1%, p < 0.05) was significantly higher in patients with stroke. Previous stroke (HR 6.85), female gender (HR 3.13), as well as STEMI anterior (HR 2.55) were independent risk factors of stroke in this population.
Conclusions: Patients with AMI treated invasively and concomitant IRF were at higher risk of stroke occurrence in the future. Stroke was associated with poor outcome in the studied population. Independent predictors of stroke in patients with IRF and AMI treated invasively were different from commonly recognized stroke predictors.
Keywords
stroke, impaired renal failure, myocardial infarction, percutaneous coronary intervention, contrast-induced nephropathy
About this articleTitle
The incidence and risk factors of stroke in patients with acute myocardial infarction treated invasively and concomitant impaired renal function
Journal
Issue
Pages
672-678
Published online
2013-04-24
DOI
10.5603/CJ.a2013.0050
Bibliographic record
Cardiol J 2013;20(6):672-678.
Keywords
stroke
impaired renal failure
myocardial infarction
percutaneous coronary intervention
contrast-induced nephropathy
Authors
Tomasz Podolecki
Radosław Lenarczyk
Jacek Kowalczyk
Andrzej Świątkowski
Piotr Chodór
Patrycja Pruszkowska-Skrzep
Agnieszka Sędkowska
Lech Poloński
Zbigniew Kalarus