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Updated: Apr 19, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Type of myocardial infarction presentation in patients with chronic kidney disease
L A Ferrara1, L Staiano1, V Di Fronzo1
1Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy.
Insights
Non S-T Elevated Myocardial Infarction (NSTEMI) is linked to worse kidney dysfunction. This study highlights the strong association between cardiac and renal impairment, suggesting shared risk factors contribute to both conditions.
Area of Science:
- Cardiology
- Nephrology
- Internal Medicine
Background:
- Epidemiological studies frequently report associations between coronary and renal diseases.
- The relationship between electrocardiographic presentations of myocardial infarction (STEMI/NSTEMI) and the severity of renal dysfunction remains unclear.
Purpose of the Study:
- To investigate the association between the type of myocardial infarction (STEMI vs. NSTEMI) and the degree of renal dysfunction.
- To explore the link between cardiac impairment and kidney dysfunction in patients with acute myocardial infarction.
Main Methods:
- Examined 146 acute myocardial infarction patients using clinical, ECG, and echocardiographic assessments.
- Calculated Glomerular Filtration Rate (GFR) using the CKD-EPI equation and categorized renal function into stages.
- Compared patient characteristics and MI presentation between different renal function groups.
Main Results:
- 71 patients had STEMI and 75 had NSTEMI.
- Renal function was normal in 61, mildly impaired in 60, and moderately to severely impaired in 25 patients.
- Patients with stages 3-4 renal impairment were older, more likely diabetic, and had more cardiovascular disease history; they were 4 times more likely to present with NSTEMI (p=0.02).
Conclusions:
- NSTEMI is associated with more severe kidney dysfunction, potentially due to prolonged exposure to shared risk factors.
- Cardiac and renal impairment are strongly interconnected, emphasizing the need for integrated patient management.
Background And Aim:
Association of coronary and renal disease has been frequently found in epidemiological studies. Whether ECG-graphic presentation of myocardial infarction [S-T Elevated MI (STEMI) or Non S-T Elevated MI (NSTEMI)] is related to the degree of renal dysfunction is still unclear.
Methods And Results:
We examined 146 patients with acute myocardial infarction, consecutively entering the Coronary Care Unit of our ward. At entry, patients underwent clinical, ECG-graphic and echocardiographic examination, and blood samples were withdrawn for cardiac markers and general biochemistry. GFR was calculated using the CKD-EPI equation. STEMI was found in 71 cases and NSTEMI in 75 cases. Renal function was normal in 61 patients (stage 1), mildly impaired (<90 mL/min/1.73 m(2) and ≥ 60 mL/min/1.73 m(2)) in 60 (stage 2) and moderately to severely impaired (GFR <60 mL/min/1.73 m(2)) in 25 cases (stages 3-4). Patients were, thereafter, clustered into two groups (stages 1-2 and stages 3-4). Compared to stage 1-2 subjects, stages 3-4 patients were older, were more likely to be diabetic and had more frequently previous cardiovascular diseases. The probability of presentation of NSTEMI for stage 3-4 patients was 4-fold greater than for stage 1-2 patients (p = 0.02).
Conclusions:
These data support the evidence that 1) NSTEMI is associated with more severe kidney dysfunction, likely due to more severe and/or longer lasting exposition to risk factors; 2) cardiac and renal impairment are strongly associated. ClinicalTrials.gov Identifier: NCT01636427.
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