Low estimated glomerular filtration rate (eGFR) and worsening renal function predict a greater risk of death among patients undergoing percutaneous coronary intervention (PCI), according to a new study.

Toshijiro Aoki, MD, from Nagoya University Graduate School of Medicine, Nagoya, Japan, and colleagues studied 442 patients diagnosed with acute myocardial infarction who underwent primary PCI. The investigators stratified patients into 2 groups: a higher eGFR group (45 mL/min/1.73 m2 or greater, 381 patients)) and a low eGFR (below 45 mL/min/1.73 m2, 63 patients). They defined worsening renal function (WRF) as an increase in serum creatinine levels of 0.3 mg/dL or greater above admission values during the course of hospitalization.

Dr Aoki and colleagues observed WRF in 88 patients (19.8%). Median follow-up duration was 769 days. At 1500 days, all-cause mortality was significantly lower in the high eGFR group compared with the low eGFR group (5.5% vs 28.6%), the investigators reported online ahead of print in Clinical and Experimental Nephrology.

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In addition, all-cause and cardiac mortality rates were significantly higher among patients with than without WRF, regardless of eGFR.

On multivariate analysis, both low eGFR and WRF were independently associated with a significant 2.6-fold increased risk of all-cause mortality.


Aoki T, Ishii H, Tanaka A, et al. Influence of chronic kidney disease and worsening renal function on clinical outcomes in patients undergoing primary percutaneous coronary intervention. Clin Exp Nephrology. 2018; published online ahead of print.