[Risk factors for Type 1 cardio-renal syndrome after ST-segment elevation myocardial infarction]
Hongwei Pan1, Ying Guo, Zhaofen Zheng
1Department of Cardiology, Hunan Provincial People's Hospital, Changsha 410005, China 474282550@qq.com.
Insights
Cardio-renal syndrome type 1 (CRS1) is a common complication following ST-segment elevation myocardial infarction (STEMI). Key risk factors include age, diabetes, and reduced heart function, while timely revascularization may lower CRS1 incidence.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- ST-segment elevation myocardial infarction (STEMI) frequently leads to cardio-renal syndrome type 1 (CRS1).
- Understanding CRS1 risk factors is crucial for patient management post-STEMI.
Purpose of the Study:
- To identify independent risk factors for developing CRS1 after STEMI.
- To assess the impact of emergency percutaneous coronary intervention (PCI) on CRS1 incidence.
Main Methods:
- A cohort of 378 STEMI patients were categorized into CRS1 (n=98) and non-CRS1 (n=280) groups.
- Clinical characteristics were compared, and multivariate logistic regression identified independent risk factors.
- The effect of emergency PCI on CRS1 was evaluated in a subgroup of patients.
Main Results:
- CRS1 occurred in 25.9% of STEMI patients.
- Independent risk factors for CRS1 included older age, diabetes history, higher systolic blood pressure, severe Killip classification, reduced left ventricular ejection fraction, lower eGFR, not undergoing emergency PCI, and not using ACEI/ARB.
- In patients undergoing emergency PCI, higher door-to-balloon time and contrast agent volume were associated with CRS1.
Conclusions:
- CRS1 is a frequent complication of STEMI, influenced by multiple clinical factors.
- Prompt revascularization through emergency PCI appears to mitigate CRS1 development in STEMI patients.
Objective:
To explore the risk factors for Type 1 cardio-renal syndrome (CRS1) after ST-segment elevation myocardial infarction (STEMI).
Methods:
A total of 378 patients with STEMI were divided into two groups: a CRS1 group (n=98) and a non-CRS1 group (n=280). Clinical characteristics in the 2 groups were compared, and independent risk factors for CRS1 after STEMI were analyzed, and the effect of emergency percutaneous coronary intervention (PCI) on CRS1 in patients after STEMI were assessed.
Results:
In the 378 STEMI patients, CRS1 was found in 98 patients (25.9%). Between the 2 groups, there was significant difference in 12 parameters, including age, history of diabetes, admission mean arterial pressure, admission systolic blood pressure, admission heart rate, Killip classification, left ventricular ejection fraction, baseline serum creatinine, baseline evaluated glomerular filtration rate (eGFR), emergency PCI, β-blockers and angiotensin converting enzyme inhibitor/angiotensin, receptor antagonist (ACEI/ARB) application (all P<0.05). Multivariate logistic regression showed that age, history of diabetes, admission systolic blood pressure, Killip classification, reduced left ventricular ejection fraction, reduced eGFR, emergency PCI nonundergo and ACEI/ARB non-use were independent risk factors for CRS1 after STEMI. In the 256 patients undergoing emergency PCI, 50 patients (19.5%) had CRS1. The door-ball time and the amount of contrast agent in the CRS1 group were significantly higher than those in the non- CRS1 group (both P<0.05), but there was no significant difference in the blood flow in the "culprit vessel" after the PCI (P>0.05).
Conclusion:
CRS1 is a common complication of STEMI, which is associated with many factors. Immediate revascularization can reduce the incidence of CRS1 in patients with ST-segment elevation myocardial infarction.
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