Chronic kidney disease, but not diabetes, can predict 30-day outcomes in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention

A single-center experience

Cheng Chung Hung, Wei Chun Huang, Kuan Rau Chiou, Chin Chang Cheng, Feng Yu Kuo, Jin Shiou Yang, Ko Long Lin, Cheng Hung Chiang, Shin Hung Hsiao, Chi Cheng Lai, Tzu Wen Lin, Guang Yuan Mar, Chuen Wang Chiou, Chun Peng Liu

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Patients with acute coronary syndrome and impaired renal function have been shown to have high mortality. However, there is scarce literature to date addressing the impact of diabetes mellitus (DM) and renal function on clinical outcomes of ST elevation myocardial infarction (STEMI) in Taiwan. Method: This study enrolled 512 STEMI patients who received primary percutaneous coronary intervention. Patients were divided into 4 groups including group 1: patients without DM or CKD (nDM-nCKD); group 2: patients with DM but without CKD (DM-nCKD); group 3: patients with CKD but without DM (nDM-CKD); group 4: patients with DM and CKD (DM-CKD). Patients were also classified into four groups based on their estimated glomerular filtration rates (eGFR): stage 1 (eGFR ≧ 90 ml/min/1.73 m2, n = 163), stage 2 (eGFR = 89-60 ml/min/1.73 m2, n = 171), stage 3 (eGFR = 59-30 ml/min/1.73 m2, n = 136), and stage 4 (eGFR < 30 ml/min/1.73 m2, n = 42). The complication rates, length of hospital stay, and 30-day outcomes were analyzed. Results: The patients in both the nDM-CKD group and DM-CKD group had higher incidences of hypotension, intra-aortic balloon counterpulsation use, and respiratory failure (p < 0.005). They had significantly longer hospital stay and 30-daymortality rates (p < 0.001). The patients with CKD stage 3 and 4 had longer hospital stay and higher 30-day mortality rates (p < 0.001). However, DM was not an independent factor on the length of hospital stay and 30-day mortality rates. Conclusions: STEMI patients with impaired renal function, but not DM, had significantly longer hospital stay and higher 30-day mortality rates.

Original languageEnglish
Pages (from-to)395-403
Number of pages9
JournalActa Cardiologica Sinica
Volume29
Issue number5
Publication statusPublished - Sep 1 2013
Externally publishedYes

Fingerprint

Percutaneous Coronary Intervention
Chronic Renal Insufficiency
Diabetes Mellitus
Length of Stay
Glomerular Filtration Rate
Mortality
Kidney
ST Elevation Myocardial Infarction
Counterpulsation
Acute Coronary Syndrome
Taiwan
Respiratory Insufficiency
Hypotension

Keywords

  • Chronic kidney disease
  • Diabetes mellitus
  • Mortality
  • Primary percutaneous coronary intervention
  • ST-segment elevation myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Chronic kidney disease, but not diabetes, can predict 30-day outcomes in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention : A single-center experience. / Hung, Cheng Chung; Huang, Wei Chun; Chiou, Kuan Rau; Cheng, Chin Chang; Kuo, Feng Yu; Yang, Jin Shiou; Lin, Ko Long; Chiang, Cheng Hung; Hsiao, Shin Hung; Lai, Chi Cheng; Lin, Tzu Wen; Mar, Guang Yuan; Chiou, Chuen Wang; Liu, Chun Peng.

In: Acta Cardiologica Sinica, Vol. 29, No. 5, 01.09.2013, p. 395-403.

Research output: Contribution to journalArticle

Hung, CC, Huang, WC, Chiou, KR, Cheng, CC, Kuo, FY, Yang, JS, Lin, KL, Chiang, CH, Hsiao, SH, Lai, CC, Lin, TW, Mar, GY, Chiou, CW & Liu, CP 2013, 'Chronic kidney disease, but not diabetes, can predict 30-day outcomes in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention: A single-center experience', Acta Cardiologica Sinica, vol. 29, no. 5, pp. 395-403.
Hung, Cheng Chung ; Huang, Wei Chun ; Chiou, Kuan Rau ; Cheng, Chin Chang ; Kuo, Feng Yu ; Yang, Jin Shiou ; Lin, Ko Long ; Chiang, Cheng Hung ; Hsiao, Shin Hung ; Lai, Chi Cheng ; Lin, Tzu Wen ; Mar, Guang Yuan ; Chiou, Chuen Wang ; Liu, Chun Peng. / Chronic kidney disease, but not diabetes, can predict 30-day outcomes in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention : A single-center experience. In: Acta Cardiologica Sinica. 2013 ; Vol. 29, No. 5. pp. 395-403.
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abstract = "Background: Patients with acute coronary syndrome and impaired renal function have been shown to have high mortality. However, there is scarce literature to date addressing the impact of diabetes mellitus (DM) and renal function on clinical outcomes of ST elevation myocardial infarction (STEMI) in Taiwan. Method: This study enrolled 512 STEMI patients who received primary percutaneous coronary intervention. Patients were divided into 4 groups including group 1: patients without DM or CKD (nDM-nCKD); group 2: patients with DM but without CKD (DM-nCKD); group 3: patients with CKD but without DM (nDM-CKD); group 4: patients with DM and CKD (DM-CKD). Patients were also classified into four groups based on their estimated glomerular filtration rates (eGFR): stage 1 (eGFR ≧ 90 ml/min/1.73 m2, n = 163), stage 2 (eGFR = 89-60 ml/min/1.73 m2, n = 171), stage 3 (eGFR = 59-30 ml/min/1.73 m2, n = 136), and stage 4 (eGFR < 30 ml/min/1.73 m2, n = 42). The complication rates, length of hospital stay, and 30-day outcomes were analyzed. Results: The patients in both the nDM-CKD group and DM-CKD group had higher incidences of hypotension, intra-aortic balloon counterpulsation use, and respiratory failure (p < 0.005). They had significantly longer hospital stay and 30-daymortality rates (p < 0.001). The patients with CKD stage 3 and 4 had longer hospital stay and higher 30-day mortality rates (p < 0.001). However, DM was not an independent factor on the length of hospital stay and 30-day mortality rates. Conclusions: STEMI patients with impaired renal function, but not DM, had significantly longer hospital stay and higher 30-day mortality rates.",
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T1 - Chronic kidney disease, but not diabetes, can predict 30-day outcomes in patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention

T2 - A single-center experience

AU - Hung, Cheng Chung

AU - Huang, Wei Chun

AU - Chiou, Kuan Rau

AU - Cheng, Chin Chang

AU - Kuo, Feng Yu

AU - Yang, Jin Shiou

AU - Lin, Ko Long

AU - Chiang, Cheng Hung

AU - Hsiao, Shin Hung

AU - Lai, Chi Cheng

AU - Lin, Tzu Wen

AU - Mar, Guang Yuan

AU - Chiou, Chuen Wang

AU - Liu, Chun Peng

PY - 2013/9/1

Y1 - 2013/9/1

N2 - Background: Patients with acute coronary syndrome and impaired renal function have been shown to have high mortality. However, there is scarce literature to date addressing the impact of diabetes mellitus (DM) and renal function on clinical outcomes of ST elevation myocardial infarction (STEMI) in Taiwan. Method: This study enrolled 512 STEMI patients who received primary percutaneous coronary intervention. Patients were divided into 4 groups including group 1: patients without DM or CKD (nDM-nCKD); group 2: patients with DM but without CKD (DM-nCKD); group 3: patients with CKD but without DM (nDM-CKD); group 4: patients with DM and CKD (DM-CKD). Patients were also classified into four groups based on their estimated glomerular filtration rates (eGFR): stage 1 (eGFR ≧ 90 ml/min/1.73 m2, n = 163), stage 2 (eGFR = 89-60 ml/min/1.73 m2, n = 171), stage 3 (eGFR = 59-30 ml/min/1.73 m2, n = 136), and stage 4 (eGFR < 30 ml/min/1.73 m2, n = 42). The complication rates, length of hospital stay, and 30-day outcomes were analyzed. Results: The patients in both the nDM-CKD group and DM-CKD group had higher incidences of hypotension, intra-aortic balloon counterpulsation use, and respiratory failure (p < 0.005). They had significantly longer hospital stay and 30-daymortality rates (p < 0.001). The patients with CKD stage 3 and 4 had longer hospital stay and higher 30-day mortality rates (p < 0.001). However, DM was not an independent factor on the length of hospital stay and 30-day mortality rates. Conclusions: STEMI patients with impaired renal function, but not DM, had significantly longer hospital stay and higher 30-day mortality rates.

AB - Background: Patients with acute coronary syndrome and impaired renal function have been shown to have high mortality. However, there is scarce literature to date addressing the impact of diabetes mellitus (DM) and renal function on clinical outcomes of ST elevation myocardial infarction (STEMI) in Taiwan. Method: This study enrolled 512 STEMI patients who received primary percutaneous coronary intervention. Patients were divided into 4 groups including group 1: patients without DM or CKD (nDM-nCKD); group 2: patients with DM but without CKD (DM-nCKD); group 3: patients with CKD but without DM (nDM-CKD); group 4: patients with DM and CKD (DM-CKD). Patients were also classified into four groups based on their estimated glomerular filtration rates (eGFR): stage 1 (eGFR ≧ 90 ml/min/1.73 m2, n = 163), stage 2 (eGFR = 89-60 ml/min/1.73 m2, n = 171), stage 3 (eGFR = 59-30 ml/min/1.73 m2, n = 136), and stage 4 (eGFR < 30 ml/min/1.73 m2, n = 42). The complication rates, length of hospital stay, and 30-day outcomes were analyzed. Results: The patients in both the nDM-CKD group and DM-CKD group had higher incidences of hypotension, intra-aortic balloon counterpulsation use, and respiratory failure (p < 0.005). They had significantly longer hospital stay and 30-daymortality rates (p < 0.001). The patients with CKD stage 3 and 4 had longer hospital stay and higher 30-day mortality rates (p < 0.001). However, DM was not an independent factor on the length of hospital stay and 30-day mortality rates. Conclusions: STEMI patients with impaired renal function, but not DM, had significantly longer hospital stay and higher 30-day mortality rates.

KW - Chronic kidney disease

KW - Diabetes mellitus

KW - Mortality

KW - Primary percutaneous coronary intervention

KW - ST-segment elevation myocardial infarction

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