Vol 72, No 3 (2014)
Original articles
Published online: 2014-03-19

open access

Page views 952
Article views/downloads 1059
Get Citation

Connect on Social Media

Connect on Social Media

The impact of renal insufficiency on in-hospital outcome in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary interventions

Łukasz Kołtowski, Adam Lewandowski, Karolina Chojnacka, Krzysztof J. Filipiak, Janusz Kochman, Grzegorz Opolski
Kardiol Pol 2014;72(3):231-238.

Abstract

Background: Chronic renal disease (CRD) is a well-known risk factor for bleeding complications in acute coronary syndrome patients.

Aim: To determine the impact of CRD with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) on periprocedural complications.

Methods: 103 patients with STEMI treated with pPCI were prospectively observed for in-hospital complications and analysed according to kidney function status. Endpoints included clinical and periprocedural outcomes. Major and minor bleedings were reported according to TIMI, REPLACE2 and EASY classifications.

Results: Patients with CRD were at greater risk of major bleeding defined by RAPLACE-2 (20.0% vs. 2.7%; p = 0.007) and TIMI(13.3% vs. 1.3%, p = 0.018) classifications and had more grade 2 EASY scale haematomas (20.0% vs. 2.7%; p = 0.007). Vascular access crossover during PCI occurred eight-fold more often among CRD patients (33.3% vs. 4.0%, p < 0.001). Grade 3 TIMI flow was achieved less frequently in CRD patients (60% vs. 89.3%, p = 0.004). CRD predisposed to contrast-induced nephropathy (35.7% vs. 5.7%; p < 0.001) and ischaemic stroke (14.3% vs. 0.0%; p = 0.004).

Conclusions: CRD in STEMI patients undergoing pPCI is a risk factor for major and minor bleeding complications including major bleeding, moderate haematomas, contrast-induced nephropathy and ischaemic stroke. Treatment and diagnostic measures should be taken in CRD patients to reduce the severity of periprocedural complications.

Article available in PDF format

View PDF Download PDF file



Polish Heart Journal (Kardiologia Polska)