Research Article

In Turkish Geriatric Patients with Myocardial Infarction Undergoing Primary PCI Risk Factors Determining in-Hospital Mortality and The Relationship Between Kidney Function

Volume: 2 Number: 1 March 30, 2023
Ömer Şatıroğlu *, Muharrem Kara
PDF Download
Farabi Tıp Dergisi Cover Farabi Tıp Dergisi
EN TR

In Turkish Geriatric Patients with Myocardial Infarction Undergoing Primary PCI Risk Factors Determining in-Hospital Mortality and The Relationship Between Kidney Function

Abstract

Geriatric population (>80 years) has an increased mortality risk due to several reasons including more extensive coronary artery disease (CAD) and impaired renal function. We investigated the relationship between in-hospital mortality and renal dysfunction in geriatric patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous intervention (PCI). We included 203 geriatric patients with STEMI who underwent primary PCI. Patients were divided into 2 groups; group 1 comprised 42 patients who died in the hospital after MI, and group 2 included 161 patients who were discharged following primary PCI. The risk factors of the patients were determined. We calculated coronary artery disease prevalence by Gensini risk score, renal function by creatinine clearance (CrCl), and compared 2 groups. The patients in group 1 who died in hospital after STEMI were older; they had more extensive CAD and lower CrCl (age: 82 ± 5 yr, 78 ± 7 yr, p<0.001; Gensini score: 70 ± 30, 42 ± 26, p: 0.001; CrCl: 46 ± 17 mL/min, 65 ± 18 mL/min, p<0.001). When multivariate analysis was performed with logistic regression, we found to be CrCl, HDL-cholesterol, and Gensini scores to be the independent predictors of in-hospital mortality (CCL: OR 1.057 (1.029-1.086), p = 0.001); HDL: OR 1.077 (1.021-1.136), p = 0.007, Gensini score: OR 0.969 (0.952-0.985), p = 0.001). Renal dysfunction increases in-hospital mortality in elderly patients with STEMI undergoing primary PCI. Renal dysfunction in elderly patients with MI is an important risk factor that increases in-hospital mortality like other cardiovascular risk factors.

Keywords

Geriatric population , ST elevation myocardial infarction , renal function , creatinine clearance , Gensini score.

References

  1. Mendis S. Cardiovascular risk assessment and management in developing countries. Vasc Health Risk Manag. 2005; 1(1): 15-18. DOI:10.2147/vhrm.1.1.15.58933.
  2. Ichikawa K, Konta T, Ikeda A, et al. Significance of past history of renal failure for the detection of high-risk individuals for cardiovascular and end-stage renal disease: analysis of data from a nationwide health checkup. Clin Exp Nephrol. 2011; 15(6): 841-847. DOI:10.1007/s10157-011-0509-y.
  3. Furuhashi T, Moroi M, Joki N, et al. The impact of chronic kidney disease as a predictor of major cardiac events in patients with no evidence of coronary artery disease. J Cardiol. 2010; 55(3): 328-336. DOI:10.1016/j.jjcc.2009.12.009.
  4. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization [published correction appears in N Engl J Med. 2008;18(4):4]. N Engl J Med. 2004; 351(13): 1296-1305. DOI:10.1056/NEJMoa041031.
  5. Meisinger C, Döring A, Löwel H; KORA Study Group. Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population. Eur Heart J. 2006; 27(10): 1245-1250. DOI:10.1093/eurheartj/ehi880.
  6. Manjunath G, Tighiouart H, Ibrahim H, et al. Level of kidney function as a risk factor for atherosclerotic cardiovascular outcomes in the community. J Am Coll Cardiol. 2003; 41(1): 47-55. DOI:10.1016/s0735-1097(02)02663-3.
  7. Yazici HU, Durak MI, Ulus T, et al. The effect of aging on outcomes of Primary percutaneous coronary Intervention in patients with acute Myocardial infarction. Turkish Journal of Geriatrics 2012; 15(3) 255-259.
  8. Morici N, De Servi S, Toso A, et al. Renal dysfunction, coronary revascularization and mortality among elderly patients with non ST elevation acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2015; 4(5): 453-460. DOI:10.1177/2048872614557221.
  9. Rampidis GP, Benetos G, Benz DC, Giannopoulos AA, Buechel RR. A guide for Gensini Score calculation. Atherosclerosis. 2019; 287: 181-183. DOI:10.1016/j.atherosclerosis.2019.05.012.
  10. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined--a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction [published correction appears in J Am Coll Cardiol 2001 Mar 1;37(3):973]. J Am Coll Cardiol. 2000; 36(3): 959-969. DOI:10.1016/s0735-1097(00)00804-4.

Details

Primary Language

English

Subjects

Health Care Administration

Journal Section

Research Article

Authors

Publication Date

March 30, 2023

Submission Date

January 19, 2023

Acceptance Date

March 17, 2023

Published in Issue

Year 2023 Volume: 2 Number: 1

IZ

https://izlik.org/JA69WH42YD

Cite

RIS / Bibtex
APA
Şatıroğlu, Ö., & Kara, M. (2023). In Turkish Geriatric Patients with Myocardial Infarction Undergoing Primary PCI Risk Factors Determining in-Hospital Mortality and The Relationship Between Kidney Function. Farabi Tıp Dergisi, 2(1), 16-21. https://izlik.org/JA69WH42YD

*The articles to be sent to the journal should be prepared according to the sample files given below. Manuscripts not prepared in accordance with the journal format will be returned to the Author(s).

1. COPYRIGHT TRANSFER FORM

2. COVER LETTER

**International Medical Journals Editorial Board (ICMJE) directive