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Renal hyperfiltration as risk factor of major adverse cardiovascular events in patients with acute myocardial

Jin Sug Kim1, Weon Kim2, Hyo-Jin Lee1

  • 1Division of Nephrology, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea.

Scientific Reports
|July 2, 2025
PubMed

Insights

Renal hyperfiltration (RHF) in acute myocardial infarction (AMI) patients is linked to increased major adverse cardiovascular events (MACEs) and mortality. Identifying RHF aids in better risk stratification for these patients.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Research

Background:

  • The interplay between cardiac and renal function is crucial, with renal hyperfiltration (RHF) potentially developing in acute myocardial infarction (AMI) patients.
  • The clinical significance of RHF in AMI patients remains incompletely understood.

Purpose of the Study:

  • To investigate the association between RHF and major adverse cardiovascular events (MACEs) in patients following AMI.
  • To determine the prognostic value of RHF for mortality and cardiac death in the AMI population.

Main Methods:

  • Analysis of a large nationwide cohort of 9561 AMI patients with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m².
  • RHF defined as eGFR > 90th percentile after adjustments; primary endpoint was 3-year MACEs.
  • Multivariable Cox-regression and propensity score-matched analyses were employed.

Main Results:

  • Patients with RHF exhibited a significantly higher cumulative incidence of MACEs.
  • RHF was independently associated with a 1.34-fold increased risk of MACEs (95% CI 1.12-1.62).
  • RHF significantly elevated the risk of all-cause mortality (HR 1.64) and cardiac death (HR 1.78), with a U-shaped association observed for MACE risk and eGFR levels above 100 mL/min/1.73 m².

Conclusions:

  • Renal hyperfiltration is an independent risk factor for adverse cardiovascular outcomes in AMI patients.
  • These findings enhance risk stratification strategies for AMI patients by incorporating RHF assessment.
  • The study highlights the importance of considering renal function beyond standard thresholds in cardiovascular risk evaluation.

Keywords:
Acute myocardial infarctionMajor cardiovascular eventsRenal hyperfiltration

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