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Creatinine clearance is independently associated with one year mortality in a primary PCI cohort with cardiogenic

M Marije Vis1, Réne J V d Schaaf, Krishan D Sjauw

  • 1Department of Cardiology, Academical Medical Centre, Amsterdam, The Netherlands.

Acute Cardiac Care
|May 19, 2009
PubMed

Insights

Creatinine clearance on admission predicts one-year mortality in ST-segment elevation myocardial infarction (STEMI) patients with cardiogenic shock (CS) treated with percutaneous coronary intervention (PCI). Lower kidney function indicates a higher risk of death.

Area of Science:

  • Cardiology
  • Nephrology
  • Critical Care Medicine

Background:

  • ST-segment elevation myocardial infarction (STEMI) with cardiogenic shock (CS) has high mortality.
  • Increasing creatinine levels in STEMI patients indicate a poor prognosis.
  • Limited data exists on kidney function in STEMI patients with CS.

Purpose of the Study:

  • To evaluate the prognostic significance of creatinine clearance (CrCl) on admission.
  • To assess CrCl's association with mortality in STEMI patients experiencing CS.
  • To analyze outcomes in patients treated with percutaneous coronary intervention (PCI).

Main Methods:

  • Retrospective analysis of 3038 STEMI patients treated with PCI (1997-2005).
  • Identified 292 patients with CS on admission.
  • Calculated CrCl for 193 patients and stratified them into tertiles for mortality analysis.

Main Results:

  • One-year mortality was 34% overall.
  • Mortality rates were 24% (CrCl > 96.8 ml/min), 30% (67.5-96.8 ml/min), and 45% (< 67.5 ml/min).
  • Each lower tertile of admission CrCl was associated with a 96% increased odds of mortality (OR 1.961).

Conclusions:

  • Admission creatinine clearance is a strong predictor of one-year mortality.
  • This finding is significant for STEMI patients with CS undergoing PCI.
  • Kidney function assessment on admission is crucial for risk stratification.
Abstract

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