Background Acute kidney injury(AKI)was a risk factor for poor outcomes in patients with ST-segment elevation myocardial infarction(STEMI).Whether postoperative serum creatinine(SCr)level measured at early time(24 hour...Background Acute kidney injury(AKI)was a risk factor for poor outcomes in patients with ST-segment elevation myocardial infarction(STEMI).Whether postoperative serum creatinine(SCr)level measured at early time(24 hours)after percutaneous coronary intervention(PCI)had prognostic role in elderly patients with STEMI was unclear.Methods SCr was measured within 24 hours after PCI.A total of 883 elderly patients(≥60 years)with STEMI were finally included and divided into three group according to the tertiles of postoperative SCr level(umol/L):<81(n=283),81-107(n=302)and≥107(n=298).The relationship between postoperative Scr and in-hospital and 1-year adverse events was evaluated.Results In-hospital mortality was 5.4%(48/883),which was significantly higher in patients with a high postoperative SCr level(1.8%vs.3.0%vs.11.4%,P<0.001).Receiver operator characteristic curve analysis indicated that postoperative SCr>120 umol/L had a sensitivity of 66.7%and specificity of 79.2%for predicting in-hospital death[area under the curve(AUC)=0.768,95%CI:0.697-838,P<0.001].Multivariate analysis showed that postoperative Scr>120 umol/L was an independent risk factor for in-hospital mortality even after adjusting for the baseline renal dysfunction[estimated glomerular filtration rate(e GFR)<60 m L/(min·1.73 m2)].Kaplan-Meier analysis showed that patients with postoperative SCr>120 umol/L had a higher one-year mortality than those without(Log-rank test:57.8,P<0.001).Conclusions SCr level measured within 24 hours after PCI could serve as an early and powerful marker for predicting in-hospital and one-year mortality in elderly patients with STEMI.展开更多
文摘Background Acute kidney injury(AKI)was a risk factor for poor outcomes in patients with ST-segment elevation myocardial infarction(STEMI).Whether postoperative serum creatinine(SCr)level measured at early time(24 hours)after percutaneous coronary intervention(PCI)had prognostic role in elderly patients with STEMI was unclear.Methods SCr was measured within 24 hours after PCI.A total of 883 elderly patients(≥60 years)with STEMI were finally included and divided into three group according to the tertiles of postoperative SCr level(umol/L):<81(n=283),81-107(n=302)and≥107(n=298).The relationship between postoperative Scr and in-hospital and 1-year adverse events was evaluated.Results In-hospital mortality was 5.4%(48/883),which was significantly higher in patients with a high postoperative SCr level(1.8%vs.3.0%vs.11.4%,P<0.001).Receiver operator characteristic curve analysis indicated that postoperative SCr>120 umol/L had a sensitivity of 66.7%and specificity of 79.2%for predicting in-hospital death[area under the curve(AUC)=0.768,95%CI:0.697-838,P<0.001].Multivariate analysis showed that postoperative Scr>120 umol/L was an independent risk factor for in-hospital mortality even after adjusting for the baseline renal dysfunction[estimated glomerular filtration rate(e GFR)<60 m L/(min·1.73 m2)].Kaplan-Meier analysis showed that patients with postoperative SCr>120 umol/L had a higher one-year mortality than those without(Log-rank test:57.8,P<0.001).Conclusions SCr level measured within 24 hours after PCI could serve as an early and powerful marker for predicting in-hospital and one-year mortality in elderly patients with STEMI.
