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Impact of chronic kidney disease on postinfarction inflammation, oxidative stress, and left ventricular remodeling

Kotaro Naito1, Toshihisa Anzai, Tsutomu Yoshikawa

  • 1Division of Cardiology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.

Journal of Cardiac Failure
|December 2, 2008
PubMed

Insights

Chronic kidney disease (CKD) worsens outcomes after myocardial infarction (MI). CKD patients experienced more cardiac events and adverse left ventricular (LV) remodeling, linked to increased inflammation and oxidative stress.

Area of Science:

  • Cardiology
  • Nephrology
  • Biomarkers

Background:

  • Chronic kidney disease (CKD) is associated with poor clinical outcomes in patients following myocardial infarction (MI).
  • The underlying mechanisms linking CKD and adverse post-MI outcomes, particularly concerning left ventricular (LV) remodeling, remain incompletely understood.

Purpose of the Study:

  • To investigate the prognostic significance of CKD in patients with MI.
  • To determine the relationship between CKD and LV remodeling after MI.

Main Methods:

  • Study included 120 patients with a first anterior ST-elevation MI who underwent reperfusion therapy.
  • Patients were stratified into two groups based on the presence (estimated glomerular filtration rate <60 mL/min/1.73 m²) or absence of CKD.
  • Clinical outcomes, LV remodeling parameters (volume and ejection fraction), and inflammatory/oxidative stress markers were assessed.

Main Results:

  • CKD patients exhibited higher in-hospital cardiac death and heart failure readmission rates.
  • CKD was associated with greater LV volume and reduced LV ejection fraction at 2 weeks post-MI.
  • CKD independently predicted major adverse cardiac events (hazard ratio=3.13, P=.001).
  • Elevated levels of interleukin-6, C-reactive protein, and malondialdehyde-modified low-density lipoprotein were observed in CKD patients.

Conclusions:

  • CKD patients face poorer clinical outcomes post-MI compared to non-CKD patients.
  • CKD accelerates infarct expansion and LV remodeling, associated with heightened inflammation and oxidative stress.
  • CKD significantly impacts the development of LV remodeling after myocardial infarction.
Abstract

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